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Identity of emotional triggers in epilepsy. This communication describes a technique of stimulated recall and video replay which has reduced the frequency of seizures in five epileptic patients. Each of the patients had long standing partial epilepsy with complex symptomatology of the psychomotor type. It was generally acknowledged that emotional factors played an important role in their poor seizure control. Previous psychotherapeutic efforts had been without benefit because ictal amnesia had erased the memory of the stressful antecedent message-input which had triggered the seizures. Creation of empathetically stressful responses to presentation of audio and video tape recordings of specific problematic social interactions was sufficient to induce seizures in these patients. Video tape recording of the seizure and the antecedant events provided by means by which the patients could acquire otherwise unrecognized or forgotten information. Once equipped with the identity of the specific emotional trigger, the patient could avoid the kinds of events which might be expected to induce a seizure and be better able to cope with threatening environmental cues when encountered in the future. | 16 |
Self-retaining intraurethral stent: an alternative to long-term indwelling catheters or surgery in the treatment of prostatism. The self-retaining intraurethral coil is a device to stent the urethra in men who have severe urethral obstruction. It allows them to empty their bladders and still remain continent and sexually active. The device can be used in place of long-term indwelling catheters or as an alternative to surgery. During 1 year, we inserted the stent in 26 men who were poor operative risks. The treatment was successful in 20 (77%). All 20 were able to void satisfactorily. Four of the 20 resumed sexual activity, which previously had been prevented by indwelling catheters. Two patients who had delayed prostatic surgery because of fear of impotence were able to empty their bladders properly and to remain sexually active. Three patients subsequently had surgery, two after anticoagulant therapy could be stopped and one after renal function improved. No difficulties caused by the stent were encountered during surgery. Follow-up was for 2-12 months. Four patients who had had the stent in place for 12 months had no difficulties. In 16 of the 18 patients who had indwelling catheters and infected urine before insertion of the stent, sterilization of the urine was obtained after relatively short courses of antibiotic treatment. Short-term complications associated with the stent were incontinence or urinary retention. These were treated by repositioning the stent. Frequency of urination after insertion of the stent either disappeared spontaneously or was treated with anticholinergic drugs. In six patients, frequency was so severe that removal of the stent and insertion of an indwelling catheter were necessary. Slight to mild dysuria occurred immediately after surgery in all patients but eventually disappeared. Our experience suggests that the self-retaining intraurethral stent has considerable promise for the treatment of prostatic obstruction of the urethra. | 13 |
Immunohistochemical study on the pattern of 50 kd cytokeratin in psoriasis. Three biopsies of normal skin and 15 biopsies collected from patients with psoriasis vulgaris were analyzed for the expression of the 50 kd cytokeratin using direct immunofluorescence and ABC technique before and after local treatment with anthralin 0.1% in a petrolatum base, with 0.05% betamethasone dipropionate cream, and finally, after PUVA treatment. Antiserum against the 50 kd anti-cytokeratin reacted with tissue sections of normal skin, staining cells in the basal layer, while the psoriatic skin sections before the various treatments showed a staining concerning the whole thickness of the epidermis. After the various therapies, the 50 kd cytokeratin immunoreactivity was observed only in the basal layer of those psoriatic skin sections that showed complete clinical clearing, while it was observed in the whole thickness of psoriatic patches that did not clear. These data suggest that the normalization of the 50 kd cytokeratin expression pattern can be considered as a marker of clinical remission of psoriasis. | 21 |
Cytokine messenger RNA stability is enhanced in tumor cells. Hematopoietic growth factors are produced by a number of human tumors. We extracted RNA from selected human tumor cells known to produce at least one hematopoietic growth factor and found high levels of abnormally stable cytokine messenger (m)RNA. Half-life experiments performed after preventing RNA synthesis by exposing cells to actinomycin D before RNA extraction showed stabilization of cytokine messages in tumor cells in liquid culture as well as in human tumor xenografts grown in mice. Exposure to the phorbol ester phorbol 12-myristate 13-acetate (TPA) caused enhancement of granulocyte-macrophage colony-stimulating factor (GM-CSF) message level in lung cancer cells and in control fibroblasts but elevated levels persisted far longer in the tumor cells. In normal cells, an AU-rich sequence in the 3' untranslated region of cytokine mRNAs confers lability to the message. Although a beta-globin gene expression vector containing this region appears to produce unstable mRNA in lung cancer cells, cytokine mRNAs, which also contain this sequence, are very stable in the tumors we studied. This may indicate that another region of the cytokine mRNA molecule is of greater importance than the AU-rich region in determining mRNA stability in tumor cells. | 17 |
Development of a sensitive and specific 14C-serotonin release assay for platelet-activating factor (PAF) in human neutrophils. A modified, sensitive and specific serotonin release assay has been developed for the routine determination of PAF in human neutrophils. PAF-mediated release of the serotonin from rabbit platelets served as the principle of the bioassay. Prior to the assay, the sample containing PAF underwent a three-step extraction and purification process, namely Bligh and Dyer extraction, high-performance liquid chromatography (HPLC) purification and an additional post-HPLC Bligh and Dyer extraction. The overall recovery after the three-step extraction and purification process was never less than 70%. Rabbit platelets were labeled with 14C-serotonin and gel-filtered on Sephadex CL-2B column before using for the PAF assay. A standard curve was prepared for the serotonin release with known amounts of PAF between 10 and 1000 fmol. The sensitivity of the assay was 10 fmol/tube, which still caused approximately 5% of the maximum serotonin release. Our method is simple, accurate, sensitive and rapid for routine measurements of PAF in human neutrophils. | 15 |
Antibody recognition of an immunogenic influenza hemagglutinin-human leukocyte antigen class II complex. The A/Japan/57 influenza hemagglutin (HA) peptide HA 128-145, when bound by human histocompatibility leukocyte antigen-DRw11 cells, is recognized by the human CD4+ T cell clone V1. A rabbit antiserum has been raised against HA 128-145 which recognizes not only the free peptide, but also the HA 128-145/DRw11 complex on a solid matrix, in solution, or on the surface of viable cells. The detection of these complexes on viable cells was shown to be class II specific, DRw11 restricted, and commensurate with the level of DRw11 expression. The identity of DRw11 as the cell surface molecule binding HA 128-145 was confirmed by immunoprecipitation, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and tryptic peptide mapping. Using this antiserum HA 128-145/DRw11 complexes could be detected on the cell surface as soon as 30 min after the peptide was added, and increased up to 24 h. Dissociation kinetics showed these complexes were long-lived, with a half-life of approximately 14 h. This anti-HA peptide antiserum represents the first direct means of studying antigenic peptide-human leukocyte antigen class II complexes on the surface of living cells without the addition of a non-amino acid moiety to the peptide. The properties of this antiserum thus provide the potential to study naturally processed antigenic peptides as well as the mechanism of processing itself in a physiologically relevant system. | 21 |
What's new in the role of complement in diseases? The importance of complement in the potentiation of the immune response is now firmly established. More recently, however, evidence has accumulated which suggests that complement may influence biological events following non-immunologically mediated tissue damage. Several of the many different genetically controlled structural forms of complement components, which are now recognised, have been shown to influence immunoregulation and disease susceptibility. Furthermore, molecular and genetic analyses have revealed that some of the regulatory elements such as S-protein may have multiple biological functions. As a consequence, it is likely that reference to detailed functional and molecular properties of various complement components, with special reference to regulatory elements will provide new insights into mechanisms of pathogenesis of disease. | 19 |
Relaxin receptors in mice: demonstration of ligand binding in symphyseal tissues and uterine membrane fragments. A monocomponent, high specific activity, carrier-free porcine relaxin tracer (125I) has made it possible for us to demonstrate relaxin receptors in the symphysis pubis, uterus, and ovary via autoradiography. The receptors are concentrated in the symphyseal ligament and the peripheral layers of uterus and ovary. Specific relaxin binding was observed in crude membrane preparations of uteri, ovaries, and brain, whereas crude membranes of leg muscle and kidney showed only nonspecific binding. Uterine membranes prepared from estrogen-primed mice showed tracer binding, which could be significantly inhibited by porcine relaxin in a dose-dependent manner, but not by insulin. A linear Scatchard plot suggested the presence of only one kind of receptor and a dissociation constant of 5 x 10(-10) M, which is commensurate with an electrostatic double ion pair binding mechanism. | 18 |
[Hereditary familial neuropathies: genetic counseling and early diagnosis in primary care]. We present 5 cases of sensitive-motor hereditary neuropathies which were detected or controlled in primary care. Four patients had Charcot-Marie-Tooth disease (type I) and the remaining patient is a carrier of Dejerine-Sottas disease (type III). Regardless of the age of presentation of the disease, the evolution has been slow but steady in all cases. Talipes cavus is the most frequent secondary deformity. An electroneuromyographic study and a neural biopsy were the complementary diagnostic tests used. Three of the patients presented family antecedents. We believe that early diagnosis, family study and genetic advice are of great importance in primary care. | 13 |
Changes in dorsoventral but not rostrocaudal regionalization of the chick neural tube in the absence of cranial notochord, as revealed by expression of engrailed-2. Notochord has been implicated in previous studies in both the dorsoventral and rostrocaudal patterning of the developing neural tube. This possibility has been further explored by analyzing the expression of Engrailed-2 in chick embryos developing with cranial notochord defects. Control embryos containing intact notochords expressed Engrailed-2 protein within the neural tube and in a subset of the neural crest and overlying surface ectoderm at the future mesencephalon and cranial metencephalon levels. Within the neural tube, expression was confined to cell nuclei in the roof plate and lateral walls; floor plate nuclei directly overlying the notochord typically failed to show expression. After surgical removal of Hensen's node, the source of notochord precursor cells, embryos were cultured through neurulation and assayed for expression of Engrailed-2 protein. All embryos that partially or completely lacked cranial notochord expressed Engrailed-2 in a pattern similar to that of control embryos containing intact notochords, except that when notochord and floor plate were absent, Engrailed-2 was also expressed in the most ventral part of the neural tube. These results indicate that 1) Engrailed-2 expression is suppressed in the most ventral neural tube owing to induction of the floor plate by the notochord, and 2) that the presence of an underlying notochord is not required for correct rostrocaudal expression, suggesting that multiple pathways act in the patterning of the rudiment of the central nervous system. | 21 |
A phase II trial of goserelin (Zoladex) in relapsed epithelial ovarian cancer. Thirty patients with advanced epithelial ovarian cancer were treated with the luteinising hormone releasing agonist, goserelin. There were two partial responses lasting 40 and 105 weeks respectively. In addition five patients had disease stabilisation lasting 25, 35, 40, 66 and 70 weeks respectively and 23 patients had progressive disease. No significant or unexpected toxicities occurred. This minimally toxic therapy halted disease progression for 6 months or more in 23% of patients, the majority of whom were heavily pretreated. There were five early deaths due to disease progression. The use of goserelin in patients with epithelial ovarian cancers resistant to or relapsing soon after first line platinum based chemotherapy needs to be further evaluated. | 14 |
Transplantable acinar cell carcinoma of the rat pancreas. An acinar cell carcinoma of the pancreas, which developed in a F-344 rat after long-term nafenopin administration, was serially transplanted into inbred weanling rats by subcutaneous and intraperitoneal routes. The transplantability rate was 95% or more by both routes. The tumor implants became palpable in 20 to 30 days after subcutaneous transplantation, increasing in size rapidly thereafter during the next 25 to 30 days. In intraperitoneal recipients the abdomen was markedly distended within 1 month. No metastases were observed in this series of transplantations. Amylase and lipase levels in serum and tumor homogenates increased with tumor size. Morphologically, only a few cells contained zymogen granules immediately after the appearance of a palpable tumor; at later intervals, however, these granules were observed in many tumor cells. Seventy-two hours after the surgical removal of tumors, the serum amylase and lipase levels returned to control values. This transplantable pancreatic acinar cell carcinoma can be dissociated into functionally viable single cells by a simplified enzyme digestion and divalent cation chelation procedure. By light microscopic autoradiography, approximately 20% of these isolated cells were found to incorporate (3)H-thymidine in vitro into nuclear DNA. The data presented in this paper should serve as a baseline for future studies on this transplanted tumor. | 15 |
Hypertension without peripheral insulin resistance in spontaneously hypertensive rats. We performed euglycemic clamp studies with labeled glucose to measure insulin's effect on hepatic glucose output (HGO) and peripheral glucose clearance in eight conscious mobile spontaneously hypertensive rats (SHR) and eleven normotensive Wistar-Kyoto (WKY) rats age 9-10 wk. Systolic blood pressure was elevated in the SHR (P less than 0.001), whereas means of 12-h-fasted plasma insulin (P greater than 0.4), glucose (P greater than 0.07), HGO (P greater than 0.25), and glucose clearance (P greater than 0.2) did not differ significantly between groups. Infusions of human insulin into SHR and WKY rats (1 and 1.5 mU.min-1.kg-1, respectively) during concomitant somatostatin administration reestablished basal insulinemia in both groups. Neither HGO (P greater than 0.15) nor glucose clearance (P greater than 0.3) differed significantly between SHR and WKY rats under those conditions. Somatostatin plus higher-dose insulin infusions (4 mU.min-1.kg-1 in SHR and 3 or 6 mU.min-1.kg-1 in WKY rats) resulted in physiological hyperinsulinemia in all rats. Insulin sensitivity, calculated as the increase in glucose clearance effected by an increase in circulating insulin during higher-dose insulin infusions, did not differ significantly between SHR and WKY groups (P greater than 0.3). HGO was completely suppressed in SHR and WKY rats during the higher-dose insulin infusions. Our data indicate that hypertension is present in SHR at an age when insulin-mediated glucose disposal is not different from age-matched WKY rats. These findings do not support a role for peripheral insulin resistance in the genesis of hypertension in SHR. | 17 |
Morphometric analysis of phrenic motoneurons in the cat during postnatal development. The dendritic geometry of 20 phrenic motoneurons from four postnatal ages (2 weeks, 1 and 2 months, and adult) was examined by using intracellular injection of horseradish peroxidase. The number of primary dendrites (approximately 11-12) remained constant throughout postnatal development. In general, postnatal growth of the dendrites resulted from an increase in the branching and in the length and diameter of segments at all orders of the dendritic tree. There was one exception. Between 2 weeks and 1 month, the maximum extent of the dendrites increased in parallel with the growth of the spinal cord; however, there was no increase in either combined dendritic length or total membrane surface area. In addition, there was a significant decrease in the number of dendritic terminals per cell (59.8 +/- 9.3 vs. 46.4 +/- 7.4 for 2 weeks and 1 month, respectively). The distance from the soma, where the peak number of dendritic terminals per cell occurred, ranged from 700-900 microns at 2 weeks and 2 months to 1,300-1,700 microns in the adult. The diameter of dendrites as a function of distance from the soma along the dendritic path increased with age. The process of maturation tended to increase the distance from the soma over which the surface area and dendritic trunk parameter (sigma d1.5/D1.5) remained constant. The three-dimensional distribution of dendrites was analyzed by dividing space into six equal volumes or hexants. This analysis revealed that the postnatal growth in surface area in the rostral and caudal hexants was proportionately larger than that in either the medial, lateral, dorsal, or ventral hexants. Strong linear correlations were found between the diameter of the primary dendrite and the combined length, surface area, volume, and number of terminals of the dendrite at all ages studied. | 15 |
Inhibition of the development of spontaneous hypertension in SH rats by gonadectomy or estradiol. Young male and female rats that become spontaneously hypertensive when they mature were gonadectomized at 30 days of age while they were still normotensive. Gonadectomy retarded the usual steep ascent of blood pressure up to 120 days of age. Ovariectomized females "escaped" from this inhibiting effect, and blood pressure rose to severely high levels, i.e., 210 mm Hg, from 150 to 240 days. Treatment with testosterone or estradiol demonstrated that estradiol was particularly effective in inhibiting the usual rise in blood pressure in intact (sham-operated) or gonadectomized males and females. Although effectively lowering blood pressure, estradiol also caused increased pituitary and adrenal weights, hyperlipidemia, and increased circulating levels of corticosterone and DOC. | 17 |
[Reconstruction of the tubular epithelium of allotransplanted kidneys of man in late periods following transplantation]. The structure of allotransplanted kidneys (AK) from human cadavers that remained in the recipient's body for a long time (4 months-6 years) has been studied. AK that preserved good function up to the patient's death not consequent on the transplant insufficiency showed a weak immunocellular connective tissue, with the epithelium of proximal canaliculi being cytologically reconstructed. The reconstruction lay in formation of numerous polykaryocytes having a hypertrophied brush-like outline. This phenomenon ("proximal polykaryocytosis") is assessed as a manifestation of regeneratory potencies of the epithelium of AK proximal tubules in late periods after transplantation. Chronic moderate hypoxia of AK was conducive to reconstruction of the epithelium of the nephron proximal part. Inadequate function of AK was related to the development of chronic rejection resistant to the treatment, and AK demonstrated an intensive immunocellular reaction and developed gross sclerosis that produced atrophy of most AK tubular. | 19 |
Characterization of the major promoter for the plasmid-encoded sucrose genes scrY, scrA, and scrB. Sucrose genes from a Salmonella thompson plasmid were cloned in Escherichia coli K-12. A physical map and a genetic map of the genes were constructed, revealing strong homology with the scr regulon from the Salmonella typhimurium plasmid pUR400. Two promoters were examined after being subcloned into transcriptional fusion vectors. Primer extension analysis and site-directed mutagenesis were used to identify the precise location of the promoter of scrY, scrA, and scrB. Transcription from this promoter was regulated over a 1,000-fold range by the combined effects of ScrR-mediated repression and catabolite repression. A putative cyclic AMP receptor protein binding site centered 72.5 bp upstream of the start point of transcription of scrY appeared to be essential for full activity of the scrY promoter. Transcription from the putative scrK promoter was far less sensitive to repression by ScrR. In ScrR+ cells, readthrough transcription from the putative scrK promoter into scrY accounted for less than 10% of scrY expression. | 14 |
Interrelationships between Water and cellular metabolism in Artemia cysts. VIII Sorption isotherms and derived thermodynamic quantities. An analysis of water vapor sorption by cysts of the brine shrimp, Artemia salina, has shown that at environmental water activities (aw) of 0.95 or less, the cysts equilibrate with the aw of their environment. Above this aw the metabolic activity of the cysts participates directly in their water content, and equilibration does not occur. In contrast, dried cysts killed by heat treatment or exposure to ammonia fumes equilibrated with all values of aw examined. Analysis of the temperature dependence of sorption isotherms revealed that below cyst hydrations of about 0.3 g H2O/g dried weight the temperature coefficient for water sorption was negative, but became positive at hydrations appreciably in excess of this value. Estimates for the differential and integral net enthalpy and entropy changes accompanying the sorption of water have been calculated from isotherms. These results have been interpreted and integrated with those from previous work on the hydration-dependence of metabolic activity. All of the examined hydration properties of the cysts have been shown to be due chiefly to the cellular component, and not the acellular shell. Analysis of the data by the Bradley equation has shown that the hydration behavior of the shell obeys this relationship, whereas that of the cellular component does not. | 16 |
Norepinephrine:adenosinetriphosphate ratios in purified adrenergic vesicles. Norepinephrine (NE):adenosinetriphosphate (ATP) ratios were studied in a highly purified fraction of large dense core vesicles isolated from the bovine splenic nerve. Vesicles prepared from nerves chilled approximately 10 and 30 min post mortem were compared. The NE:ATP molar ratio decreased from 6.3 to 4.8, p less than 0.005; NE decreased from 61 to 42 nmol, while ATP decreased only from 9.6 to 8.8 nmol/mg protein. Animals weighing 180-360 kg were compared with heavier ones weighing 400-700 kg. NE increased from 42 to 68 nmol and ATP increased from 5.9 to 13.2 nmol/mg protein, while the NE:ATP molar ratio decreased from 7.2 to 5.2, p less than 0.005. Changes during vesicle maturation were studied by comparing vesicles identically prepared from equal weights of a proximal nerve segment close to the coeliac ganglion and a distal, intrasplenic segment. NE increased from 45 to 70 nmol while ATP remained unchanged at 10.0 nmol/mg protein and the NE:ATP molar ratio increased from 4.5 to 7.0, p less than 0.005. It was interpreted that vesicle ATP content, like dopamine beta-hydroxylase, was established early in the cell body and remained unchanged during axoplasmic transport. ATP was in a complex which was relatively stable to post mortem hydrolysis at least between 10 and 30 min prior to chilling the nerves. The addition of newly synthesized NE into a readily releasable pool during axoplasmic transport occurs without ATP and can account for the increased ratio above 4:1 in the distal segment vesicles. | 15 |
Synthesis and biological evaluation of new muscarinic receptor antagonists bearing cyclic amidines as cationic heads. Two classes of compounds, bearing a cyclic amidino moiety instead of the tertiary amino group of the classical antimuscarinic drugs like hexahydrodifenidol 3 were synthesized. Affinities (KD) for the three pharmacologically defined M1, M2 and M3 mAChR subtypes were measured in radioligand binding assays and in functional in vitro studies (KB) in guinea pig ileum and left atrium. The results showed that the replacement of the tertiary amino group in structural analogues of 3 with a cyclic amidino moiety afforded potent antimuscarinic compounds. The selectivity shown for smooth muscle preparations suggests their usefulness as antispasmodics. | 18 |
Maintaining the health-for-all momentum. The efficiency and effectiveness of the health-for-all strategy have been judged largely by the results achieved in the developing countries. Assessments of progress have, for the most part, failed to take account of the slowness of advances previously made in the developed countries, and to allow for the fact that health services develop in parallel with teaching institutions and other bodies. In most African countries the whole process has been hindered by worsening economic, social and legal conditions. In considering how the momentum of the health-for-all strategy may be maintained, this article argues against undue bias towards the profit motive, which could lead to many people having access to only second-class services. | 15 |
Formation of a thymine photoproduct in transforming DNA by near ultraviolet irradiation. Irradiation at 334 and 365 nm of a highly purified preparation of thymine-labeled transforming DNA from Haemophilus influenzae produced a photo product containing label from thymine but different from the cyclobutane dimer. The photoproduct is soluble in water and in ethanol and Rf values in a number of solvents are presented. The photoproduct has properties similar in a number of respects to those of the spore photoproduct, 5-thyminyl-5,6-dihydrothymine. The near ultraviolet photoproduct is more likely to affect the oxygen independent inactivation of transforming DNA rather than its mutagenesis, as judged by the quantitative relationship between amount of photboproduct and inactivation and mutagenesis. | 19 |
[Evaluation of the arterial share of portal flow using a scintigraphic technique in patients with liver cirrhosis. Correlations with other parameters of portal hypertension]. This study aimed to measure in semiquantitative terms the arterial-venous ratio of the portal flow using a scintigraphic technique, by means of a simple intravenous injection of a 99mTcDiethylHIDA bolus, a method which was found to be extremely simple and non-invasive, with a good degree of repeatibility. The percentage of arterialisation of the portal flow was found to be higher in cirrhotic patients compared to non-hepatopathic subjects, and among cirrhotic patients it was correlated with the severity of disease, the presence and degree of esophageal varices, and the presence of porto-systemic shunts, assessed using the ammonium chloride test. | 20 |
Effect of ACTH 4-10 on passive avoidance of rats lacking vasopressin (Brattleboro strain). The hypothesis that the effects of ACTH 4-10 on avoidance are mediated via the release of endogenous vasopressin was investigated. To test this hypothesis, we observed the effect of ACTH 4-10 on the passive avoidance of Brattleboro rats with diabetes insipidus resulting from a total genetic deficiency of vasopressin (DI) and Brattleboro rats without diabetes insipidus (HE). Normal Long-Evans rats (LE) were also included for comparison purposes. The results did not support the hypothesis. ACTH 4-10 did influence the passive avoidance of DI rats; this should not have occurred if the release of endogenous vasopressin is necessary for ACTH 4-10 to influence avoidance. | 14 |
The effect of carboxyl substituent on the metabolism of aromatic aldehydes. 1. The effect of a carboxyl substituent on the metabolism of aromatic aldehydes has been examined in several species of animals. 2. Phthalaldehydic acid was exclusively reduced to the corresponding alcohol in mice, rats, rabbits, dogs and man. The oxidized metabolite phthalic acid was not detected appreciably in any species. 3. Iso- and terephthalaldehydic acid were oxidized to the corresponding dicarboxylic acids in rats and dogs. The reduced metabolites were not detected. 4. The aldehyde group of o-formylphenoxyacetic acid and o-formylphenoxypropionic acid was largely reduced to the corresponding alcohol in rats, rabbits and dogs. In contrast, oxidation to the carboxylic acid predominant over the reduction in mice. In the former three species, the amount of the minor metabolite carboxylic acid was larger with o-formylphenoxypropionic acid than with o-formylphenoxyacetic acid. 5. 1,8-Naphthaldehydic acid, m- and p-formylphenoxyacetic acid were mainly oxidized to the corresponding carboxylic acids in rats. 6. It was concluded that aromatic aldehydes bearing a carboxyl group in the ortho position, attached either directly or indirectly to the benzene nucleus, tend to be reduced to the corresponding alcohols in animals. | 12 |
Evidence for a direct reticulocyte origin of dense red cells in sickle cell anemia. To explore our hypothesis of a direct reticulocyte origin of irreversibly sickled cells (ISCs), we fractionated light, reticulocyte-rich, and discocyte-rich sickle anemia red cells on Stractan gradients, and examined the effects of deoxygenation-induced sickling, external Ca2+, acidification, and replacing external Na+ by impermeant N-methyl-D-glucamine (NMG+). Sickling permeabilized light reticulocyte-rich cells to cations (Na+, K+, and Ca2+) more than discocytes; without external Ca2+, Na+ influx matched K+ efflux, with stable cell volume; with Ca2+, many light, low hemoglobin (Hb) F reticulocytes dehydrated rapidly (preventable by quinine, a Ca2(+)-dependent K+ channel inhibitor). Acidification of oxygenated discocytes (high mean Hb F) and reticulocyte-rich fractions yielded denser, reticulocyte-enriched cells with lower Hb F (as in light reticulocyte or dense ISC-rich fractions). Light cells shrank when NMG+ replaced Na+, supporting predictions of a Na(+)-dependent volume control system. Demonstration of sickling-induced, Ca2(+)-dependent dehydration of Hb F-free reticulocytes, and conservation of acid-stimulated K:Cl cotransport among low Hb F, reticulocyte-enriched cells in discocyte fractions support the hypothesis. Ancillary new findings included heparin stimulation of sickling-induced Na+ and K+ permeabilizations, and Ca2+ inhibition of the Na+ leak. | 21 |
A descriptive study of blood in the mouth following routine oral endotracheal intubation. Oral endotracheal intubation and extubation are two routine procedures performed by anesthesia providers which could lead to breaches of mucosal integrity and slight or moderate bleeding, thereby providing a vector for transmission of a blood-borne disease. This study was designed to determine the incidence of occult or overt blood in the oral and pharyngeal areas during the intubation and extubation periods. A convenience sample of 163 patients from 18 to 70 years of age who underwent an oral endotracheal intubation for general anesthesia were included. Within 15 minutes of endotracheal intubation, the patients were tested at five designated sampling sites for the presence of overt or occult blood. The results demonstrated that blood was present after 34% of the intubations, with 70% of those being positive in the oral/pharyngeal cavity and 52% exhibiting blood on the laryngoscope blade. Upon extubation 72% were positive, with 97% of those being positive at the distal tip of the endotracheal tube. The blood found during both these events was primarily occult. The results suggest that the potential for blood, both overt and occult, to be present in the mouth of patients is significant enough to recommend that all practitioners adhere to the universal barrier precautions to limit their exposure to the transmission of potentially fatal blood-borne viruses. | 17 |
Longitudinal growth study of Tasmanian children. 2. The seven-year-olds. A longitudinal growth study of Tasmanian children, involving 1,114 infants born between September 1, 1967, and August 31, 1968, has continued into the seventh year during 1974-1975, when measurements of height and weight were recorded on the 898 remaining children that could be traced. A portion of the results is presented here. The main findings is that a high percentage of children who are overweight at the age of three years is likely to be overweight at seven years. Birth weight is not an important factor in determining the weight of a seven-year-old. Children over the 90th percentile at age three years are, on the average, more than 5 kg heavier at seven years than children between the 10th and 90th percentiles at three years. The seven-year-old weights themselves do not appear to have altered in the past two decades, being virtually identical to those in the 1957 Standard Tables for Australian Children. | 10 |
Structure and dynamics of des-pentapeptide-insulin in solution: the molten-globule hypothesis. Structures of insulin in different crystal forms exhibit significant local and nonlocal differences, including correlated displacement of elements of secondary structure. Here we describe the solution structure and dynamics of a monomeric insulin analogue, des-pentapeptide-(B26-B30)-insulin (DPI), as determined by two-dimensional NMR spectroscopy and distance geometry/restrained molecular dynamics (DG/RMD). Although the solution structure of DPI exhibits a general similarity to its crystal structure, individual DG/RMD structures in the NMR ensemble differ by rigid-body displacements of alpha-helices that span the range of different crystal forms. These results suggest that DPI exists as a partially folded state formed by coalescence of distinct alpha-helix-associated microdomains. The physical reality of this model is investigated by comparison of the observed two-dimensional nuclear Overhauser enhancement (NOE) spectroscopy (NOESY) spectrum with that predicted from crystal and DG/RMD structures. The observed NOESY spectrum contains fewer tertiary contacts than predicted by any single simulation, but it matches their shared features; such "ensemble correspondence" is likely to reflect the effect of protein dynamics on observed NOE intensities. We propose (i) that the folded state of DPI is analogous to that of a compact protein-folding intermediate rather than a conventional native state and (ii) that the molten state is the biologically active species. This proposal (the molten-globule hypothesis) leads to testable thermodynamic predictions and has general implications for protein design. | 20 |
Secondary hyperparathyroidism in CAPD patients: its suppressibility with high doses of calcitriol. Secondary hyperparathyroidism (HP) is well known complication of long-term uremia. CAPD patients show a peculiar behaviour due to loss of vitamin D metabolites through peritoneum. Severe degrees of hyperparathyroidism may require parathyroidectomy in order to achieve appropriate control. Recently, the possibility of controlling this situation with high oral doses of calcitriol has been communicated. The purpose of this study is to evaluate the effect of this agent on hyperparathyroidism in CAPD patients. Two different groups were constituted according to the length of time on dialysis when HP was detected. All of the patients had i-PTH serum levels five times higher than the normal values (50 pg/ml). During a six month period the daily dose of oral calcitriol was increased in order to achieve a reduction in i-PTH level. The results after this period showed a significant reduction in i-PTH levels (614 +/- 378 to 241 +/- 80 pg/ml) with an average increase in oral calcitriol from 0.16 +/- 0.1 to 0.67 +/- 0.4 with no significant changes in serum calcium or phosphorus. The group with HP at start of dialysis achieved these effects easier and with lower doses of calcitriol. We conclude that moderately high doses of oral calcitriol control secondary hyperparathyroidism in CAPD patients without hypercalcemia. | 13 |
Respiratory mechanics in recumbent dogs anesthetized with thiopental sodium. Pressure-volume (PV) and conductance-volume (GV) curves were obtained in trained dogs awake and then anesthetized with thiopental sodium, in the prone left lateral decubitus, and supine positions. By paired analyses, induction of anesthesia had no significant effect on lung volumes, static PV curves of the lung or chest wall, or static compliance of the lung or chest wall. In addition, change of posture had little effect on these variables in either the awake or the anesthetized state. Frequently, however, individual dogs showed changes in lung PV curves after induction of anesthesia or change of posture. These PV curve shifts were not accompanied by predictable changes in GV relations. Therefore, we concluded that such changes in the lung PV curve reflect either local artifacts or local deformation of the respiratory system. | 14 |
[Influence of rapeseed oil on lipoprotein lipase activity in pigs (author's transl)]. Toxic activities in various animal species have shown for rapeseed oil. In this paper the influence of this oil on lipoprotein lipase activity of heart, liver and lung of pigs has been examined. The animals were fed with rapeseed oil with 40% erucic acid for 7, 15, 20 and 40 days. The control animals received olive oil. The results have shown a slight increase in the lipoprotein lipase activity in the heart of the pig after 20 days with rapeseed oil. In the liver this increase is particularly large in the pigs having been fed for 15 days both with rapeseed oil and olive oil. No differences were observed in the lung in the test and control animals with the only exception of animals fed for 20 days. | 11 |
Nuclear factors which bind to Dictyostelium discoideum transfer RNA genes. RNA Polymerase III transcription factors from the cellular slime mold Dictyostelium discoideum were characterized, based on their stable binding to isolated tRNA genes. Different protein complexes are sequestered on DNA fragments containing tRNA genes depending on the conditions by which the nuclei were extracted. Binding specificity was determined through competition assays using competitor tRNA genes from the same gene family, from different gene families and from truncated tRNA genes. The complex with the highest multiformity of interdependent proteins is able to assemble with low affinity on a B-block-free tDNA template, whereas most lower molecular weight complexes require the presence of an intact B-block promoter element in order to assemble. | 17 |
Ice hockey injuries: incidence, nature and causes. In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors. | 11 |
A macro and micro view of coronary vascular insult in ischemic heart disease. Atherosclerotic plaques are either concentric, producing a fixed degree of obstruction, or eccentric, with retention of an arc of normal vessel wall that allows changes in medial muscle tone to vary the degree of stenosis. Plaques may also either be solid and fibrous or may contain, in addition to fibrous thickening, a pool of extracellular cholesterol. Most subjects with ischemic heart disease have mixtures of all plaque types. The endothelium over established human plaques often shows focal denudation injury, with adhesion of a platelet monolayer not detectable by angiography. Larger thrombi are due either to superficial intimal injury, which is the progression of the endothelial denudation seen over otherwise static and intact plaques, or to deep intimal injury caused by plaque fissuring (rupture). Both forms of intimal injury expose collagen and von Willebrand factor to platelets. In deep injury, tears extend from the lumen into the depths of the intima and often enter a lipid pool; in consequence, thrombus initially forms within the plaque, thereby altering its configuration and expanding its volume. Many fissures will reseal at this stage, but the plaque is larger, and the process is an important cause of episodic sudden plaque growth. A proportion of plaque fissures are associated with the additional formation of a luminal thrombus, which may be either mural or occlusive. In life, transitions between mural and occlusive thrombi and vice versa occur rapidly and frequently. Mural thrombus is associated with distal embolization of platelet masses and, in some cases, is associated with cholesterol from the plaque.(ABSTRACT TRUNCATED AT 250 WORDS) | 15 |
Significance and validity of a shortened lead chelation test. We evaluated the chelation test in 38 subjects exposed to lead or with suspected lead exposure, comparing the values of lead excretion at the 3rd h (PbU EDTA/3-h) and at the 24th h (PbU EDTA/24-h) after EDTA administration. Good correlation exists between PbU EDTA/3-h and PbU EDTA/24-h (r = .86) and between them and the main biological indicators of dose and effect of lead. When a second chelation test was performed in 15 subjects, a slightly better r coefficient (.93) was observed between the two tests, without reaching statistical significance. It seems difficult, in terms of the type of exposure that we considered, to use the 3-h test, on an individual basis, to predict the PbU EDTA/24-h values. | 16 |
Epidemiology of antibiotic resistant Neisseria gonorrhoeae in industrialized and developing countries. The in vitro susceptibility of Neisseria gonorrhoeae to antimicrobial drugs has been studied currently for around fifty years, and it has been convincingly demonstrated that the results of the in vitro determinations can be used as a guideline for choice of an efficient standard treatment regimen as well as for the choice of therapeutic agent in individual cases. During these past 50 years, the susceptibility of gonococci to antimicrobial drugs has undergone dramatic changes. The genetic background is chromosomal mutations as well as the acquisition of R plasmids. The selective pressure has been exerted both by use (and misuse) of antibiotics in treatment of patients and by factors in the micro-environment of the gonococcus. Review of the current spectrum of antimicrobial susceptibility patterns of N. gonorrhoeae in industrialized and developing countries and a comparison with the changing epidemiology of gonorrhoea, rises the question as to what extent antimicrobial resistance and the choice of treatment regimen influence the spread of gonorrhoea (and other sexually transmitted diseases). In the developed countries, in spite of the access to an optimal antibiotic treatment, the prevalence of gonorrhoea increased significantly in the beginning of the 1970s and remained at a high level until around 1985. Then--within the following subsequent few years--the gonorrhoea rate fell dramatically e.g. in Scandinavia. This fall coincides with the establishment of comprehensive educational programmes for the promotion of changes in sexual lifestyle. It is therefore tempting to conclude that the impact of increasing antimicrobial resistance on the changing epidemiology of gonorrhoea is minor. | 17 |
RNA methylation in vaccinia virus-infected chick embryo fibroblasts treated with homologous interferon. Interferon-pretreatment of vaccinia-infected chick embryo fibroblasts resulted in a greater than 50% decrease in ribose methylation of the penultimate "cap" nucleotide in virus-specific mRNA. However, in contrast to results obtained with cell-free systems, in intact infected cells there was (a) no detectable reduction in methylation of the 5'-ultimate m7G of viral mRNA; (b) a virus specificity of the interferon-induced change in mRNA "CAP"-methylation seems unlikely and (c) analysis of the ribosomal and transfer RNA fractions isolated from interferon-treated and control cells revealed identical patterns of methylated nucleotides. Thus, the interferon-induced change in methylation is specific for mRNA "CAPS". | 21 |
Childhood haemangiomas of the head and neck. Haemangiomas of the head and neck in children may be of several histological types, the clinical course depending on the group to which the haemangioma belongs. Treatment may be required if the haemangioma interferes with the airway, as in the subglottic group, or if the lesion becomes ulcerated with subsequent haemorrhage, as in capillary cavernous haemangiomas. Most haemangiomas require no immediate treatment as they involute spontaneously, though parental reassurance will be of paramount importance. Those lesions which persist may be amenable to treatment at a later date, the laser probably offering the best long-term results in terms of cosmesis as in the case of port-wine stains. Superselective embolization is becoming the treatment of choice for arterial haemangiomas. This paper is designed to clarify the histological and clinical features of these tumours and their management in view of considerable confusion in the literature encountered in our study. | 16 |
Physiological factors influencing serum bile acid levels. This study defines the effects of fasting (prolongation of an overnight fast for a further four hours), feeding (the response to eating the three main ;solid' meals of the day), and cholecystokinin-induced gallbladder contraction (75-100 units of CCK given as a bolus intravenous injection) on serum individual bile acids in five to eight healthy control subjects. The serum conjugates of the two primary bile acids, cholic and chenodeoxycholic, were measured using sensitive specific radio-immunoassays. During fasting, there was no significant change in the levels of the serum individual bile acids (conjugates of cholate, 1.28 +/- 0.19; conjugates of chenodeoxycholate, 1.17 +/- 0.17 mumol/l). After breakfast, the serum conjugates of cholate and chenodeoxycholate increased significantly but thereafter the mean values remained high with less consistent responses to lunch and dinner, some subjects showing a peak and trough response to all three meals, while others showed a plateau response throughout the day. After breakfast, the serum chenodeoxycholate conjugates increased more rapidly (peak at 60 minutes when the concentration reached 2.07 +/- 0.30 mumol/l) and to a greater extent than the conjugates of cholate (peak at 90 minutes; 1.50 +/- 0.24 mumol/l). A similar pattern of results was seen after intravenous CCK, suggesting either preferential jejunal absorption of chenodeoxycholate conjugates and/or preferential hepatic clearance of cholate conjugates. These results provide essential background data for future studies of serum individual bile acids in intestinal and hepatic disease. | 19 |
2:1 and phase 4 peri-infarction block. A patient with acute inferior and anteroseptal myocardial infarction initially developed a 2 : 1 AV block with alternate conducted ventricular complexes showing aberrancy, and later Wenckebach-type, 2nd-degree AV block with aberrancy of the beats following a long diastolic pause. Intracavitary recording suggested that aberrancy was related to an intraventricular block. ECG and VCG recordings excluded the site of block as being in the main bundles or in the fascicles of the left bundle. The patient therefore showed evidence for a 2 : 1 and later a phase 4 peripheral block, defined also as a peri-infarction block because of the underlying etiology of the block. The block could be localized in the posterior wall of the right ventricle, by the marked rightward and posterior orientation of the middle and terminal electrical forces evident in the vectorcardiogram. | 17 |
[Involvement of oxytocin in spinal cord in acupuncture analgesia]. The influence of intrathecal injection of oxytocin (OT), anti-OT serum (AOTS) and naloxone on pain threshold and electroacupuncture (EA) analgesia in rats was investigated. The tail-flick induced by potassium iontophoresis was used to measure the pain threshold. The increase in pain threshold was observed within 70 min after OT injection (100 ng), and it was much more effective than that of the ACSF injection (P less than 0.001). The OT administration could enhance the EA analgesia. This effect was of dose-related. Although injection of AOTS did not affect the pain threshold, it diminished EA analgesia. Furthermore, injection of naloxone did not influence the action of OT on EA analgesia. Our results showed that OT in spinal cord plays an important role in the EA analgesia, and its effects is independent of endogenous opiate peptides. | 12 |
Two-dimensional transesophageal echocardiographic determination of aortic valve area in adults with aortic stenosis. To determine if aortic stenosis severity could be accurately measured by two-dimensional transesophageal echocardiography (TEE), 62 adult subjects (mean age 66 +/- 12 years) with aortic stenosis had their aortic valve area (AVA) determined by direct planimetry using TEE, and with the continuity equation using combined transthoracic Doppler and two-dimensional echocardiography (TTE). Eighteen subjects had AVA calculated by the Gorlin method during catheterization. An excellent correlation (r = 0.93, SEE = 0.17 cm2) was found between AVA determined by TEE (mean 1.24 +/- 0.49 cm2; range 0.40 to 2.26 cm2) and TTE (mean 1.23 +/- 0.46 cm2; range 0.40 to 2.23 cm2). The absolute (0.13 +/- 0.12 cm2) and percent (10.8 +/- 8.9%) differences between AVA determined by TEE versus TTE were small. Excellent correlations between AVA by TEE and TTE were also found in subjects with normal systolic function (r = 0.95, SEE = 0.14 cm2; n = 38) and impaired function (r = 0.91, SEE = 0.21 cm2; n = 24). AVA determined by catheterization correlated better with AVA measured by TEE (r = 0.91, SEE = 0.15 cm2) than AVA measured with TTE (r = 0.84, SEE = 0.19 cm2). These data demonstrate that AVA can be accurately measured by direct planimetry using TEE in subjects with aortic stenosis. TEE may become an important adjunct to transthoracic echocardiography in the assessment of aortic stenosis severity. | 16 |
Administration of excitatory amino acid antagonists via microdialysis attenuates the increase in glucose utilization seen following concussive brain injury. Immediately following concussive brain injury, cells exhibit an increase of energy demand represented by the activation of glucose utilization. We have proposed that this trauma-induced hypermetabolism reflects the effort of cells to restore normal ionic balance disrupted by massive ionic fluxes through transmitter-gated ion channels. In the present study, changes in local CMRglc following fluid-percussion concussive injury were determined using [14C]2-deoxy-D-glucose autoradiography, and the effects of in situ administration (via microdialysis) of excitatory amino acid (EAA) antagonists [kynurenic acid (KYN), 2-amino-5-phosphonovaleric acid (APV; 100 microM, 1 mM, and 10 mM), and 6-cyano-7-nitroquinoxaline-2,3-dine (CNQX; 300 microM, 1 mM, and 10 mM] on glucose utilization were investigated. Animals that did not receive dialysis showed a remarkable increase (up to 181% of normal control) in cortical glucose utilization following injury. In contrast, this high demand for glucose was reduced in areas infiltrated with KYN, APV, and CNQX. These results indicate that EAA-activated ion channels are involved in the posttraumatic increase in glucose utilization, reflecting the energy demand of cells required to drive pumping mechanisms against an ionic perturbation seen immediately following the concussive injury. The effects of KYN, APV, and CNQX suggest that although all subtypes of the glutamate receptor appear to be involved in this phenomenon, N-methyl-D-aspartate-activated channels may play a major role. | 22 |
An integrated nursing model of depressive behavior in adults. Theory and implications for practice. Accumulating evidence suggests that cognitive processes or stimuli associated with a stressor may influence the neurochemical state. In addition, it has been suggested that a person's coping responses may protect him or her from the biologic dysregulations implicated in depression. From a nursing care perspective, the proposed model suggests the following practice components. First, assessment not only should include the symptom profiles of each client but should address both physical and psychosocial stressors. Second, once identified, individualized care needs to incorporate a variety of interventions that focuses on the target components (i.e., cognitive interventions for negative thought patterns, interventions to build interpersonal skills, sleep hygiene principles, pharmacologic interventions, and so forth). Finally, one needs to address how having experienced episodes of depression may influence the client's self-perception and ongoing quality of life. Nurses must begin to understand how the experience of having a depressive episode itself may serve as an ongoing stressor for the client. The factors that maintain depressive behavior and influence recurrence need to be the central focus of mental health nursing from a research and clinical perspective. It is this attention to integration and recurrence that will define nursing's unique contributions to this important area of mental health. | 15 |
Breast-milk amylase activity in English and Gambian mothers: effects of prolonged lactation, maternal parity, and individual variations. Breast milk contains an amylase that may contribute to carbohydrate digestion in infants. The aim of our study was to determine whether mothers differ in their breast-milk amylase activity and whether the activity is maintained during prolonged lactation. This was investigated by measuring breast-milk amylase activity by hydrolysis of maltotetraose in 63 English mothers of parity 1-5 and 107 Gambian mothers of parity 1-12 who were at various stages of lactation (0.5-27 mo). Amylase was present in all samples and showed a great range of activity from 0.08 to 3.53 IU/mL. Amylase activities did not vary during a feed nor over 24 h, and each mother had a characteristic level of activity in her milk. Amylase activity was higher in the 1st trimester of lactation, and decreased by 35% (p less than 0.001) to a plateau at 6-27 mo. Gambian mothers of very high parity (parity 11-12) had 54% of the activity of primiparous mothers (p less than 0.001), after adjustment for stage of lactation. Using community data on milk volume, the estimated breast-milk amylase intake by breast-fed children was on the order of 800-1000 IU/24 h in the 1st trimester and 400 IU/24 h in the 2nd year of lactation. Individual measurements emphasized the great differences in this intake among children of the same age. Our study showed that breast milk is an important source of amylase both in developed and developing countries, but there are large variations in intake among children. | 16 |
[Survival of Escherichia coli cells during storage in suspensions of varying concentrations]. The presence of positive correlative connection between death rate of Escherichia coli M-17 cells and the density of their suspension have been estimated. It has been shown, that the accumulation in extracellular medium (ECM) of death-stimulating (DS) metabolites, the concentration of which was higher in the suspensions of higher densities, was the immediate cause of the acceleration of death in suspensions with densities higher than 1 x 10(9) cells/ml. DS metabolites could be removed from ECM by adsorption or dialysis, and, thus, they had comparably low molecular mass. The presence of DS metabolites led to the acceleration of death of test-cultures E. coli M-17. The filtrates of ECM of suspensions with density lower than 1 x 10(9) cells/ml did not accelerate the death rate of test-cultures, and, most probably, did not contain any DS-substances. It is supposed, that the role of DS-substances is the maintenance of optimal size of the population of bacteria. The low effective concentrations of these substances make it possible to consider that their functions are nothing but regulatory. | 15 |
[Cytological structure of the lymph nodes after administration of foreign protein]. Changes in the cellular compositon of popliteal lymphatic nodes of albino rats were studied in normality and after injection of a foreign protein. Allergic inflammation was caused by injection of 0,25 ml of the horse serum. Observations were made on the 1, 3, 8, 19 and 30 days after the beginning of experiment. The cellular composition was counted in 30 visual fileds in the cortical plateu, follicles and myelinated cords. The average percentage of cellular elements has been determined. It has been shown that the reticular cells have less changes as compared with other cells in response to antigen stimulation. An inverse correlative relationship was noted between small and medium-sized lymphocytes. The greatest percentage of plasmic cells was noted in myelinated cords; in the follicles they are found as solitary units. In the primary immunization the cellular composition of follicles was little changed as compared with the cellular composition of the cortical and medullary substance. The cellular reaction was most pronounced in myelinated cords. Thus, the investigation of the cellular composition of different structure components of the rat's lymphatic nodes after injection of the foreign protein has revealed a different degree of their reaction. | 14 |
Intra-articular and circulating immune complexes and antiglobulins (IgG and IgM) in rheumatoid arthritis; correlation with clinical features. Solid phase radioimmunometric methods have been used to assay immune complexes and IgG and IgM antiglobulins in paired samples of synovial fluid and serum from patients with rheumatoid arthritis (RA) or osteoarthrosis. Over 60% of RA patients had some increase in complexes in their sera, while nearly 90% had synovial fluid complexes. Moreover, the levels of complexes within the joint were much higher than in the serum. Both IgG and IgM antiglobulins were raised in most RA patients. The levels of IgG antiglobulins--and to a less extent IgM antiglobulins--were nearly always higher in synovial fluid than in the corresponding serum sample.A strong correlation was found between the levels of immune complex and IgG antiglobulin. A marked association was seen between the presence of subcutaneous nodules and increased IgG antiglobulins. | 14 |
Evaluation of isradipine and captopril alone or in combination for the treatment of hypertension. The antihypertensive effects of isradipine and captopril were studied in 231 patients with mild-to-moderate hypertension in a double-blind, randomized, between-patient trial. Treatment was started with 1.25 mg of isradipine or 12.5 mg of captopril twice daily which, if normotension was not obtained, was increased after 4 weeks to 2.5 mg or 25 mg twice daily, respectively. If the maximum dose of each drug alone did not result in normotension, captopril (12.5 mg or, if necessary, 25 mg twice daily) was added to the isradipine regimen, and isradipine (1.25 mg or, if necessary, 2.5 mg twice daily) to the captopril regimen. Following 24 weeks of active treatment, systolic blood pressure (SBP) was significantly (p less than 0.001) reduced by isradipine (170 +/- 17 vs. 153 +/- 17 mm Hg) and by captopril (170 +/- 19 vs. 155 +/- 19 mm Hg). Diastolic blood pressure (DBP) also fell significantly (p less than 0.001) in both groups (isradipine: 106 +/- 5 vs. 93 +/- 8 mm Hg; captopril: 106 +/- 5 vs. 95 +/- 10 mm Hg). After isradipine as monotherapy, DBP was normalized in 49% of patients compared with 52% after captopril monotherapy. Combination of both drugs increased the normalization rate to 84%. The results indicate that combined treatment with a calcium antagonist and an angiotensin-converting enzyme (ACE) inhibitor is effective in lowering blood pressure, and is well tolerated as long-term therapy. | 17 |
Interrelations between plasma renin activity, aldosterone, and sympathetic nervous system activity in essential hypertension. Interrelations were investigated between plasma renin activity (PRA), dopamine-beta-hydroxylase activity (DBH), plasma aldosterone (PA), plasma cortisol (PC) and plasma sodium concentration (PNa) in renal vein blood of essential hypertension patients in recumbent position. The patients were divided in compliance with the WHO classification into two groups of stage I and stage II of essential hypertension. In stage I a negative correlation was found in all samples of blood between PA and PNa. This means that in recumbent position in stage I the mechanism of regulation sodium -- aldosterone is maintained. In stage II there were very significant correlations between DBH and PRA in the samples from both renal veins. The left renal vein blood gives the best information about secretion of the left adrenal gland. In stage II in samples from the left renal vein a negative correlation was proved between PA and PRA, and also two very similar negative correlations PA -- DBH and PC -- DBH were demonstrated. The results indicate that in recumbent position in stage II the renin secretion is mainly under the control of the sympathetic nervous system, even if the activity of the latter is depressed, normal or enhanced. The possible negative relation between sympathetic activity and corticosteroid secretion in stage II of essential hypertension is discussed. | 17 |
Factors related to the oxygen tolerance of anaerobic bacteria. The effect of atmospheric oxygen on the viability of 13 strains of anaerobic bacteria, two strains of facultative bacteria, and one aerobic organism was examined. There were great variations in oxygen tolerance among the bacteria. All facultative bacteria survived more than 72 h of exposure to atmospheric oxygen. The survival time for anaerobes ranged from less than 45 min for Peptostreptococcus anaerobius to more than 72 h for two Clostridium perfringens strains. An effort was made to relate the degree of oxygen tolerance to the activities of superoxide dismutase, catalase, and peroxidases in cell-free extracts of the bacteria. All facultative bacteria and a number of anaerobic bacteria possessed superoxide dismutase. There was a correlation between superoxide dismutase activity and oxygen tolerance, but there were notable exceptions. Polyacrylamide gel electropherograms stained for superoxide dismutase indicated that many of the anaerobic bacteria contained at least two electrophoretically distinct enzymes with superoxide dismutase activity. All facultative bacteria contained peroxidase, whereas none of the anaerobic bacteria possessed measurable amounts of this enzyme. Catalase activity was variable among the bacteria and showed no relationship to oxygen tolerance. The ability of the bacteria to reduce oxygen was also examined and related to enzyme content and oxygen tolerance. In general, organisms that survived for relatively long periods of time in the presence of oxygen but demonstrated little superoxide dismutase activity reduced little oxygen. The effects of medium composition and conditions of growth were examined for their influence on the level of the three enzymes. Bacteria grown on the surface of an enriched blood agar medium generally had more enzyme activity than bacteria grown in a liquid medium. The data indicate that superoxide dismutase activity and oxygen reduction rates are important determinants related to the tolerance of anaerobic bacteria to oxygen. | 18 |
Oxalyl hydroxamates as reaction-intermediate analogues for ketol-acid reductoisomerase. N-Hydroxy-N-isopropyloxamate (IpOHA) is an exceptionally potent inhibitor of the Escherichia coli ketol-acid reductoisomerase. In the presence of Mg2+ or Mn2+, IpOHA inhibits the enzyme in a time-dependent manner, forming a nearly irreversible complex. Nucleotide, which is essential for catalysis, greatly enhances the binding of IpOHA by the reductoisomerase, with NADPH (normally present during the enzyme's rearrangement step, i.e., conversion of a beta-keto acid into an alpha-keto acid, in either the forward or reverse physiological reactions) being more effective than NADP. In the presence of Mg2+ and NADPH, IpOHA appears to bind to the enzyme in a two-step mechanism, with an initial inhibition constant of 160 nM and a maximum rate of formation of the tight, slowly reversible complex of 0.57 min-1 (values that give an association rate of IpOHA, at low concentration, of 5.9 X 10(4) M-1 s-1). The rate of exchange of [14C]IpOHA from an enzyme-[14C]IpOHA-Mg2(+)-NADPH complex with exogenous, unlabeled IpOHA has a half-time of 6 days (150 h). This dissociation rate (1.3 X 10(-6) s-1) and the association rate determined by inactivation kinetics define an overall dissociation constant of 22 pM. By contrast, in the presence of Mn2+ and NADPH, the corresponding association and dissociation rates for IpOHA are 8.2 X 10(4) M-1 s-1 and 3.2 X 10(-6) s-1 (half-time = 2.5 days), respectively, which define an overall dissociation constant of 38 pM. In the presence of NADP or in the absence of nucleotide (both in the presence of Mg2+), the enzyme-IpOHA complex is far more labile, with dissociation half-times of 28 and 2 h, respectively. In the absence of Mg2+ or Mn2+, IpOHA does not exhibit time-dependent inhibition of the reductoisomerase.(ABSTRACT TRUNCATED AT 250 WORDS) | 17 |
[Electron microscopic study on the focal immune response in the choroid (author's transl)]. Pigmented rabbits were sensitized by subcutaneous injection of BCG together with Freund's complete adjuvant and heat killed tubercle bacilli together with adjuvant. After the titer of serum antibody to BGG was elevated or tuberculin skin test became positive, choroiditis was induced in these eyes by an injection of BGG or PPD directly through the posterior sclera in the vicinity of the optic nerve. The eyes were enucleated at various intervals and the choroid was studied by light and electron microscopy. In the choroid challenged with BGG, infiltrates such as polymorphonuclear leukocytes and lymphocytes were seen, in early stages, invading in the posterior segment and peripheral area near the ciliary body. These cells decreased in number within a few days, and after one week a few plasma cells were detected in the posterior uvea. In the choroid challenged with PPD, infiltration of monocytes and lymphocytes was seen in early stages, reaching its peak in 48 hours. After 4 and 5 days lymphocytes decreased in number, but monocytes showed mitotic and phagocytotic activity, and accumulated near the sclera. After one week typical epithelioid cells were detected along the suprachoroidal space. These events were restricted within the choroid. The results obtained suggest, that in the focal immune reaction of the choroid, the cellular sequence of events and the range of tissue involved are different depending upon the kinds of antigen used. It may indicate humoral immunity on one side and cell-mediate immunity on the other. | 16 |
Enzyme-linked immunosorbent assay for hepatitis B surface antigen. A solid-phase enzyme-linked immunosorbent assay (ELISA), based on the "sandwich" principle with use of microtiter plates, was developed for the detection of hepatitis B surface antigen (HBSAg). Results could be read within one day by the naked eye or by colorimeter. The detection level was less than or equal to 5-10 ng of HBSAg/ml. The sensitivities of ELISA and radioimmunoassay were about the same in dilution series and in a follow-up study of 19 patients with acute hepatitis B infection. In 11 European medical centers where greater than 50,000 samples were tested, ELISA detected significantly more HBSAg-positive samples than a reversed hemagglutinatiom test. No significant difference in sensitivity between ELISA and radioimmunoassay could be demonstrated. On the average, 2.2% of readings were false-positive reactions. Falsely positive samples were identified by a confirmatory test. | 13 |
Measuring technical efficiency in health care organizations. The rising cost of health care has created great interest in developing methods to increase the efficiency of health care organizations. Despite this interest most analyses of prospective payment and other programs designed to control expenditures have examined costs and not efficiency. This article examines a new technique--data envelopment analysis (DEA)--that facilitates the conduct of efficiency studies. The utility of DEA is analyzed by comparing this technique with other methods used to measure efficiency, by discussing the application of DEA in the health care industry and by assessing the validity of results from DEA studies. The article concludes with an assessment of the strengths and weaknesses of DEA and suggestions for refining this technique. | 16 |
[Investigation of the immunity status towards tetanus of a population of mechanics at the car-factory "Renault" (author's transl)]. Tetanus immunity has been studied in a population of mechanics working at the car-factory "Renault". For the study, 283 individuals were divided into 3 groups. The first group consisted of non-vaccined individuals, the second of vaccinated individuals and the third of individuals who had been boostered. The influence of different parameters on tetanus immunity status was considered, i. e. the age of the subjects, the time at which boostering was given, the serotherapy (when it was administered) and the contact with machine lubricating and cooling fluids. Clostridium tetani bacilli and spores were frequently found in aqueous machine fluids. Their presence is a potential hazard for non-vaccinated mechanics coming to contact with the fluids. Tetanus antibody levels in the sera of the tested population were determined in vivo by the toxin neutralization test. The influence on tetanus immunity of the different parameters considered in this paper was subjected to statistical analysis. From the whole population, 27% of the individuals were found to have no protection against tetanus. When age was taken into account, 53% of the individuals over 45 years old and 10% of those under 45 years old were shown to be devoid of tetanus immunity. It could be shown that younger individuals were better protected than older ones, because the formers had been immunized with adsorbed tetanus toxoid and most of the latters with fluid toxoid. Of the individuals in the third group who had received a booster injection within 15 years after primo-vaccination, 98% showed protective tetanus antibody levels in their sera in contrast to 25% when boostering had occurred more than 15 years after primo-vaccination. Contact with machine fluids was found to influence the degree of immunity of only those individuals whose boostering dated back to more than 25 years. Unexpectedly, 3 mechanics seemed to develop immunity after coming into contact with machine fluids. From the results reported here, it is concluded that tetanus immunity in vaccinated individuals should be renewed by a compulsory booster injection given every 5, 10 or, at the minimum, 15 years. Moreover, high-risk populations such as that represented by the mechanics should be immunized or boostered on commencing employment. | 15 |
[Nervous system diseases in workers of a large metallurgical plant. II. Impact of occupational factors]. Correlation between some factors connected with work performance in a big metallurgical plant, employing approximately 16000 persons, and the occurrence of nervous system diseases was analysed. It was found that among the most frequent diseases of nervous system cured in neurological dispensary of a big metallurgical plant are: ischias, epilepsy, syndrome of subjective ailments following a past cranio-cerebral trauma and vasomotor headaches. The studies performed did not reveal any clear correlation between the character and arduousness of work and the type of nervous system diseases occurring most frequently in a big industrial (metallurgical) plant. The prevalence of ischias is not significantly dependent on occupational factors. The possibility of continuation of work or necessity to stop working in result of a nervous system disease depend on the type of the disease. | 14 |
Hypoxic apnoea induced by N2 inhalation can be reversed by the aspiration reflex in anaesthetized cats. Various cardiorespiratory and electrophysiological parameters were analysed in a model of acute respiratory failure induced by inhalation of pure nitrogen in approximately 150 anaesthetized cats. Initial hyperventilation leading to apnoea was characterized by extreme hypoxaemia, marked bradycardia and flattening of electrocortical (ECoG) activity. Artificial ventilation applied at the stage of marked mydriasis usually spontaneously prevented cardiovascular failure and normalized vital functions. Up to seven successive apnoeic attacks could be induced in the same cat. During the first 30 or 60 s of apnoea, nasopharyngeal stimulation usually elicited a typical gasp-like aspiration reflex, while tracheobronchial stimulation provoked a weak cough only in 28 and 34% of cases for 30- and 60-s apnoea, respectively. The aspiration reflex could be elicited at very low and even isoelectric ECoG activity, and its periodic provocation (without artificial ventilation) resulted, more frequently than did gasping, in recovery from hypoxic apnoea. Arousal and resuscitation induced by the aspiration reflex can provide a useful model to study the mechanisms of reversible respiratory failure and restitution of vital functions. | 21 |
The effect of early and late cord-clamping on blood viscosity and other hemorheological parameters in full-term neonates. This study was done to compare postnatal alterations in blood viscosity (capillary viscometer) and its determinants: hematocrit, plasma viscosity (capillary viscometer), red cell aggregation (Myrenne aggregometer) and red cell deformability (rheoscope) in the first five days of postnatal life in full-term neonates with early (< 10 s) and late (3 min) cord-clamping. The fetal blood volume of the placenta ("residual placental blood volume") decreased from 52 +/- 8 ml/kg of neonatal body weight after early cord-clamping to 15 +/- 4 ml/kg after later cord-clamping. Neonatal blood volume, calculated as the difference between an assumed total feto-placental blood volume of 115 ml/kg and the measured fetal blood volume of the placenta, was 50% higher in the late cord-clamped infants than in the early cord-clamped infants. Both groups showed similar viscosity, hematocrit and other rheological parameters in cord blood. In the infants with early cord-clamping, the hematocrit decreased from 0.48 +/- 0.04 l/l at birth to 0.43 +/- 0.6 l/l after 24 h (p < 0.05). Whole blood viscosity did not change significantly with age. After late cord-clamping, the hematocrit rose from 0.50 +/- 0.04% at birth to 0.63 +/- 0.05 l/l at 2 h of age (p < 0.005) and dropped to 0.59 +/- 0.5 l/l (p < 0.05) at 24 h. Blood viscosity increased by 40% (p < 0.001) within the first 2 h, but did not change significantly during the following five days. In both groups, plasma viscosity and red cell aggregation increased significantly (p < 0.05) on day 5 due to significant increases in total plasma protein and fibrinogen concentrations (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) | 17 |
Depression and cognitive change among institutionalized aged. Interrelations between depression (Geriatric Depression Scale) and cognitive impairment (Blessed test) were examined among 201 nursing home and congregate apartment residents in a 2-year, 3-wave study. In structural equations models that controlled autocorrelations and within-occasion correlated residuals, introducing paths from depression to subsequent cognitive status significantly reduced unexplained variance, whereas paths from cognitive status to subsequent depression did not. Subsidiary analyses indicated that the relation of depression to subsequent cognitive status was strongest among persons with borderline (vs. impaired or intact) cognitive status, but only for the first time interval. Discussion addresses explanations for obtained results and implications for monitoring and treating depression among elderly long-term care residents. | 21 |
Psychomotor activity as a correlate of Depression and sleep in acutely disturbed psychiatric inpatients. Combining a lightweight telemetric mobility sensing system with nightly EEG-sleep recordings, the authors obtained continuous monitoring of rest-activity cycles among psychiatric patients hospitalized for primary depression or acute schizophreniform thought disorder. The patients with primary depression had a significantly higher percentage of their total 24-hour motor activity distributed during the night. Furthermore, this increased nocturnal motor activity did not correlate significantly with concurrent EEG-sleep measures of wakefulness. Indeed, the best predictors of wakefulness were measures of daytime activity. This desynchronization of sleep and nighttime motor activity in primary depression may explain the need for combined pharmacotherapy in some severely depressed patients. The authors suggest that expressing activity as a percentage distribution function, rather than in terms of absolute amplitude, provides an objective diagnostic index of depression. | 19 |
Quantitative observations on iliac bone marrow mast cells in chronic renal failure. Mast cells have been counted in sections of iliac bone from 61 control subjects at necropsy. Mast cells were found in all but three, and the range was 0-33-7, median 1-95 per mm2 marrow. The majority (82%) had less than 4-99 mast cells per mm2 marrow; in 37-7% there was less than 1 mast cell per mm2 marrow. In a group of 45 patients with chronic renal failure there was a significant increase in the numbers of mast cells (P less than 0-001) with a range of 0-96-55-63, median 9-55 per mm2 marrow. Mast cells were common in the areas of marrow fibrosis associated with osteitis fibrosa but this was not the sole cause of the increase since there was also an excess of mast cells in the non-fibrous parts of the marrow. There was a tendency towards greater numbers of mast cells in those cases with most marked osteitis fibrosa in association with the prominent marrow fibrosis, but there was no significant relationship between mast cell numbers and other features of oesteitis fibrosa such as the number of osteoclasts and the amount of woven bone formation. There was no relationship between the numbers of mast cells and the amounts of total bone, ostoid, percentage mineralization of cancellous bone, or the presence of osteomalacia. | 14 |
[Giant aneurysm of the middle cerebral artery presenting with complex partial seizure. Case report]. A 24-year-old female who had had several attacks of complex partial seizures was admitted after minor head trauma. There was no neurological deficit on admission, but a large oval calcification was incidentally found in the left temporal region on the plain skull film. Computed tomography scan and carotid angiography revealed a giant thrombosed aneurysm which arose from the M2 portion of the left middle cerebral artery. Focal spike discharges were found on the left temporal region on conventional electroencephalography. Left frontotemporal craniotomy and opening of the left sylvian fissure disclosed a giant aneurysm at the M2 portion of the left middle cerebral artery. The neck of the aneurysm was buried in the dome of the aneurysm and the parent artery was curved at an acute angle at the site of the neck. The aneurysm was excised and end-to-end anastomosis of the main stem of the M2 portion was successfully performed. Postoperative course was uneventful and the patient became completely free from seizures. The surgical technique and the possible mechanism of complex partial seizure in this patient are described. | 13 |
[Compression of the ulnar nerve near the elbow]. The ulnar nerve is subject to an entrapment neuropathy at the elbow. The groove behind the medial epicondyle is by the adjacent structures transformed to a tunnel. This passage is the most significant entrapment point of nerve. Duurgery we treated 18 patients with the entrapment ulnar neuropathy at the elbow. Operative decompression had been performed and when necessary, anterior transposition and neurolysis under the microscope control. After the operation some of the patients had complete relief of symptoms. Lifelong cases had partly ameliorated. Three patients are described in details. In our paper we appeared the mechanism and diagnosis of cubital tunnel compression, It is pointed that early diagnosis and operative treatment are only preferable in healing the ulnar entrapment neuropathy at the elbow. | 11 |
Axonal transport of acetylcholine, choline acetyltransferase and cholinesterase in regenerating peripheral nerve. 1. The axonal transport of acetylcholine (ACh), choline acetyltransferase (ChAc) and cholinesterase (ChE) was estimated in the peroneal nerves of rabbits by measuring the accumulation of each against a nerve crush over a period of 20 hr. 2. Estimates were made of the amounts of these substances that were transported in nerves that had been regenerating for up to 111 days after being crushed or up to 13 days after being cut. 3. The initial response was the same whether the injury was a crush or a cut; the amount of ACh transported was increased, while ChAc and ChE transport was reduced. 4. The amounts of ACh, ChAc and ChE transported tended to return to normal levels when the nerves were allowed to reinnervate the denervated muscles. ChAc transport also showed an early recovery in the cut nerves. 5. The ACh content of the central nerve stump did not alter throughout regeneration but ChAc and ChE contents were reduced at the times when the transport of the enzymes was reduced. 6. These results are discussed in relation to the time course of nerve regeneration. | 9 |
[Vasculitis and neoplasms. 14 cases]. Fourteen cases of vasculitis associated with a neoplasm are reported. The vasculitides were classified as: leukocytolytic vasculitis 7, periarteritis nodosa 4, purpura rheumatica 1, cutaneous granulomatous vasculitis 1, microvasculitis nervosa 1. The neoplasms were diagnosed as: 10 hemopathies (including 4 cases of refractory anemia) and 5 solid tumors (1 patient had 2 tumors). The cutaneous manifestations (purpura, papules, subcutaneous nodules, etc.) and fever were the most common, while joint and neurological involvement were the rarest. The evolution of the vasculitis was usually corticosensitive and independent of the underlying neoplasm. A review of the literature revealed that these vasculitides (primarily leukocytolytic) were frequently associated with dysplastic myelogenous syndromes and hairy cell leukemia, while bronchopulmonary and colonic neoplasms were the most common solid tumors. The mechanisms giving rise to these vasculitides are discussed. | 15 |
A REB1-binding site is required for GCN4-independent ILV1 basal level transcription and can be functionally replaced by an ABF1-binding site. The ILV1 gene of Saccharomyces cerevisiae encodes the first committed step in isoleucine biosynthesis and is regulated by general control of amino acid biosynthesis. Deletion analysis of the ILV1 promoter revealed a GC-rich element important for the basal level expression. This cis-acting element, called ILV1BAS, is functional independently of whether GCN4 protein is present. Furthermore, unlike the situation at HIS4, the magnitude of GCN4-mediated derepression is independent of ILV1BAS. The element has homology to the consensus REB1-binding sequence CGGGTARNNR. Gel retardation assays showed that REB1 binds specifically to this element. We show that REB1-binding sites normally situated in the SIN3 promoter and in the 35S rRNA promoter can substitute for the ILV1 REB1 site. Furthermore, a SIN3 REB1 site containing a point mutation that abolishes REB1 binding does not support ILV1 basal level expression, suggesting that binding of REB1 is important for the control of ILV1 basal level expression. Interestingly, an ABF1-binding site can also functionally replace the ILV1 REB1-binding site. A mutated ABF1 site that displays a very low affinity for ABF1 does not functionally replace the ILV1 REB1 site. This suggests that ABF1 and REB1 may have related functions within the cell. Although the REB1-binding site is required for the ILV1 basal level expression, the site on its own stimulates transcription only slightly when combined with the CYC1 downstream promoter elements, indicating that another ILV1 promoter element functions in combination with the REB1 site to control high basal level expression. | 15 |
Imaging with indium111-labeled anticarcinoembryonic antigen monoclonal antibody ZCE-025 of recurrent colorectal or carcinoembryonic antigen-producing cancer in patients with rising serum carcinoembryonic antigen levels and occult metastases. We tested whether nuclear imaging with indium111 (111In)-labeled murine monoclonal (MoAb) anticarcinoembryonic antigen (anti-CEA) ZCE-025 antibody could detect recurrent disease in patients with a rising serum CEA level but negative findings for computed tomographic (CT) scans of the abdomen and pelvis, chest radiograph, and colonoscopy or barium enema. Twenty patients with a history of completely resected CEA-producing adenocarcinoma (18 with colon cancer, one with breast cancer, and one with Hodgkin's disease) and a rising serum CEA level were given an intravenous infusion of 2 mg of 111In-labeled ZCE-025 mixed with 38 mg of unlabeled ZCE-025. Planar and single-photon emission CT (SPECT) scans were acquired at 72 and 144 hours, and in 19 of the 20 patients these were positive. Of those 19, 13 underwent exploratory surgery, and cancer was found in 10, and two had a diagnostic biopsy, which confirmed cancer. Three patients who had negative laparotomies and all four patients who did not undergo surgery or biopsy were followed radiologically. In all seven, cancer was subsequently detected at the sites suggested by the ZCE-025 scan. Thus, tumor was confirmed in all 19 patients with positive scans. Five of 13 patients who were explored benefited from the study and the exploratory laparotomy, as disease was entirely resected in four or was subjected to definitive radiation therapy to the pelvis in the fifth. In two additional patients who were not explored, MoAb imaging resulted in definitive therapy to regionally confined recurrent disease. 111In-labeled anti-CEA MoAb ZCE-025 scanning in patients with rising CEA successfully imaged metastatic colorectal cancer that eluded detection by other methods and affected the care given to some. These results suggest an important role for 111In-labeled ZCE-025 scanning among patients with rising CEA and otherwise occult metastatic cancer. | 19 |
A comparative study of atropine methonitrate, salbutamol, and their combination in airways obstruction. Dose-response relationships of the cholinergic antagonist, atropine methonitrate, and the beta-adrenergic agonist, salbutamol, were examined by cumulative dose techniques. A wet aerosol, 1.5 mg atropine methonitrate produced a maximum response. The response to 200 microgram of salbutamol from a pressurised aerosol was close to maximum. Secondly, the bronchodilator response of salbutamol microgram was compared with atropine methonitrate 2 mg and placebo in 18 asthmatic patients in a randomised crossover study. In 11 of them the bronchodilator response of the combination of salbutamol and atropine methonitrate was evaluated. Atropine methonitrate produced a similar peak bronchodilator effect to salbutamol, but its effect was more prolonged, the response being significantly greater at four and six hours than with salbutamol. The combination of drugs produced a significantly greater and more lasting bronchodilatation than either of the drugs alone. Despite mild side effects, atropine methonitrate, either alone or in combination with an adrenergic drug, appears to have a place in the treatment of sever reversible airway obstruction not adequately controlled by conventional treatment. | 18 |
Ciliary activity in the tubotympanum during type I allergic reaction. The immune system is active in the tubotympanum and some middle ear diseases might be partially or exclusively immunologically mediated. However, the effect of an allergic reaction on the tubotympanic cilia remains to be elucidated. The response of normal tubotympanic cilia from the guinea pig was investigated in an in vitro experimental system to evaluate ciliary responsiveness without the influence of secretions. Mucosal samples were obtained from three different tubotympanic locations (Eustachian tube, and middle ear close to the tube (proximal site) and more distal to the tube (distal site)). Each mucosal sample was cultured in 2 ml of RPMI 1640 and 1 ml of heparinized venous blood from a nonallergic human subject, a patient with ragweed-sensitive nasal allergy, or 3 patients with Dermatophagoides farinae-sensitive nasal allergy. One microgram of D. farinae extracts was added in each chamber to evoke an in vitro allergic reaction, and the ciliary activity of the most active cell in each culture was monitored for up to 120 min. When D. farinae extracts were added into the chamber containing blood from subjects without sensitivity to D. farinae, no changes were induced in ciliary activity throughout the examination. When the same dose of allergens was added into the chamber containing blood from D. farinae-sensitive subjects, ciliary excitation was induced in the culture from the Eustachian tube and the proximal site. The peak and plateau of this phenomenon were observed at 30-40 min after the addition of the allergen, and a gradual slowdown to the baseline level was observed after the plateau. No ciliary depression was induced by an allergic reaction in the culture from the Eustachian tube or the proximal site. Such ciliostimulatory effects were correlated with D. farinae induced-percent histamine release from whole blood. In the cultures from the distal site, however, a gradual ciliodepression followed the peak of ciliary excitation. In conclusion, an in vitro allergic reaction affected the ciliary activity in the distal site, but such ciliary dysfunction was not observed in the Eustachian tube or the proximal site during such a reaction. | 18 |
Tooth surface loss and exposure to organic and inorganic acid fumes in workplace air. The effect of inorganic and organic acid fumes on teeth was explored in a cross-sectional study using blind dental examinations. A sample of 180 workers from two factories was randomly drawn. Among the 169 workers who participated in the survey, 88 were exposed to acid fumes and 81 were controls. The percentage of inorganic acid workers with tooth surface loss was 63.2%, while that for the controls was 37.7% (P less than 0.005). The corresponding figures in the organic acid company were 50.0% and 14.3% (P less than 0.02). In both companies the acid workers had significantly more often teeth with surface loss in the maxilla than their controls (P less than 0.02). Both anteriors and posteriors were affected. On the basis of the findings. it can be concluded that acid fumes at work are strongly associated with tooth surface loss. | 10 |
[Diagnosis of the acute rejection]. A questionnaire survey, concerning the immunosuppressive treatment and criteria of diagnosis in acute rejection of renal allografts, was done at 22 institutes. In 15 institutes, 3 immunosuppressive agents were used. Those agents were as follows: prednisolone (Pr.) or methyl-prednisolone (M-Pr.), cyclosporin (CsA) and azathioprine (Az.) or mizoribine (Mz.) or anti-lymphocyte globulin (ALG). A combination of 4 drugs (Pr. or M-Pr. +CsA +Az. or Mz. +ALG) was used at 4 institutes and a combination of 2 drugs (Pr. or M-Pr. +CsA) at the remaining 3 institutes. Acute rejection episodes were diagnosed by conventional criteria in all institutes. Conventional criteria were as follows: physical findings, rising serum creatinine, response to pulse therapy, rising urinary FDP, decreasing urinary Na/K ratio and radionuclide findings. In our cases, there was no significant difference between the number of acute rejection episodes by the 25 patients who underwent conventional immunosuppressive therapy (C group:M-Pr.+Az.) and the 25 patients with triple immunosuppressive therapy (T group: M-Pr. +CsA+Az.). Conventional methods were sufficient in most cases of the T as well as C group to diagnose acute rejection episodes. | 9 |
Preferred binding of bovine and porcine trypsins at two different sites on chicken ovoinhibitor. Reduced dissociation of mixed trypsin complexes. Dissociation of mixed trypsin (bovine plus porcine trypsin) complexes with chicken ovoinhibitor was used to investigate the nonequivalence of the two binding sites for trypsin on the inhibitor. Previous work has shown that 1 mol of trypsin dissociates much more rapidly than the 2nd from unmixed trypsin complexes, those containing 2 mol of one kind of trypsin, bovine or porcine, per mol of inhibitor. However, only approximately 0.5 to 0.6 mol of trypsin dissociated in the rapid step from the mixed trypsin complexes, those containing 1 mol each of bovine and porcine trypsin. Rates of the slow dissociation steps for the two types of complexes did not differ appreciably from each other. A general dissociation scheme is proposed, in which each of the 2:1 complexes can lose a trypsin molecule from either in two parrallel first order reactions, producing two different 1:1 complexes, which subsequently dissociate to yield free ovoinhibitor and a second trypsin molecule. In this scheme, both the earlier results with unmixed trypsin complexes and the preponderance (approximately 3:1) of slow dissociation from the mixed trypsin complexes can be rationalized if bovine trypsin is retained preferentially at one of the two trypsin binding sites on chicken ovoinhibitor, and porcine trypsin at the other. That is, one site allows rapid dissociation of porcine trypsin and slow dissociation of bovine trypsin, whereas the other allows rapid dissociation of bovine trypsin and slow dissociation of porcine trypsin. | 17 |
Multifactorial inheritance with cultural transmission and assortative mating. II. a general model of combined polygenic and cultural inheritance. A general linear model of combined polygenic-cultural inheritance is described. The model allows for phenotypic assortative mating, common environment, maternal and paternal effects, and genic-cultural correlation. General formulae for phenotypic correlation between family members in extended pedigrees are given for both primary and secondary assortative mating. A FORTRAN program BETA, available upon request, is used to provide maximum likelihood estimates of the parameters from reported correlations. American data about IQ and Burks' culture index are analyzed. Both cultural and genetic components of phenotypic variance are observed to make significant and substantial contributions to familial resemblance in IQ. The correlation between the environments of DZ twins is found to equal that of singleton sibs, not that of MZ twins. Burks' culture index is found to be an imperfect measure of midparent IQ rather than an index of home environment as previously assumed. Conditions under which the parameters of the model may be uniquely and precisely estimated are discussed. Interpretation of variance components in the presence of assortative mating and genic-cultural covariance is reviewed. A conservative, but robust, approach to the use of environmental indices is described. | 15 |
Maternal psychotropic medication and neonatal behavior. A sample of 29 psychiatrically ill women and a non-ill comparison group were recruited during pregnancy. Twelve of the ill mothers were receiving antipsychotic and anti-anxiety medication during the final trimester of pregnancy. The behavior of their infants was assessed at 3 and 14 days of age using the Brazelton Neonatal Behavioral Assessment Scale. Compared to infants of non-ill mothers and infants of ill nonmedicated mothers, infants whose mothers received antipsychotic drugs--particularly those in the phenothiazine family--showed a stable pattern of poor neonatal motor functioning that included tremulousness, hypertonicity, and poor motor maturity. It was speculated that this behavior was symptomatic of a neonatal abstinence or withdrawal syndrome. | 16 |
Developmental expression of neural cell adhesion molecules in the mouse neocortex and olfactory bulb. Polyclonal antibodies to N-CAM and L1 and monoclonal antibodies to epitopes of N-CAM (designated 12F11, 8A2, and 12F8) were used to investigate the spatial and temporal distribution of these neural cell adhesion molecules during the development of mouse cortex and olfactory bulb. The aim of the study was to correlate developmental events such as cell migration, dendritic and axonal outgrowth, and synaptogenesis with the appearance and disappearance of specific molecules involved in cell-cell interactions. Western transfer studies indicated that 12F8 antibody recognized polysialic acid found on embryonic N-CAM; 8A2 antibody primarily recognized the 140 kD component of N-CAM while the 12F11 antibody recognized the 180 and the 140 kD forms. The study demonstrates a high degree of cell surface molecular specialization of different compartments in developing neocortex and olfactory bulb. L1 is found on a variety of unmyelinated fiber tracts including thalamocortical fibers, olfactory nerve, and inner plexiform layer of the olfactory bulb. In contrast, N-CAM epitope recognized by 12F11 antibody is present on olfactory nerve fibers but appears later and is much weaker than L1 on thalamocortical fibers and is absent from the olfactory lobe inner plexiform layer. Dendritic regions are best labeled by 12F8 antibody; the epitope becomes faint in adult cortex but remains strongly expressed in olfactory bulb. This study reveals that widespread N-CAM expression in the central nervous system is constituted by a diversity of local expression of different molecular forms of N-CAM; their different anatomical distributions suggest they may each have unique roles. | 21 |
Effect of DDAVP on plasma renin activity in man. We have investigated in eight healthy persons the effect of a single intranasal dose of 40 microgram DDAVP on plasma renin activity (PRA) in the upright posture. During normal sodium intake there were no differences in the PRA values between the time-control and DDAVP studies. However, during sodium restriction in four subjects with higher initial PRA, DDAVP induced a 40% decrease, lasting no longer than 45 minutes. There was no change in PRA after DDAVP in the other four subjects with much lower initial levels. Although no major or consistent suppressive influence could be demonstrated in the present study, in certain persons with highly stimulated initial PRA levels a transitory slight depression may be expected after a pharmacological dose of DDAVP. | 13 |
[Infection status of Pseudorasbora parva collected from the Sunam stream with metacercariae of Metorchis orientalis]. This study revealed the infection status of P. parva with the metacercariae of M. orientalis in the Sunam stream of the Nakdong River, a well-known focus of Clonorchis sinensis. A total of 60 P. parva were divided into 4 groups by the size (80-90, 70-79, 60-69 and 50-59 mm) and were digested by pepsin-HCl solution in a 36 degrees C incubator. The metacercariae of M. orientalis were collected and counted under a stereomicroscope. A total of 3,885 metacercariae were found, and average number/fish in each group were 143, 54, 23 and 40. They were 175.3 x 155.4 microns in average size and had thick cyst wall(13.1 microns in average). By the results, it is proved that the life cycle of M. orientalis is actively maintained in the Sunam stream of the Nakdong River. | 13 |
Angiogenic activity is defective in monocytes from patients with alopecia universalis. Monocyte/macrophages are important components of cell-mediated immune responses in presentation of antigen, as regulators of lymphocyte function, and as sources of cytokines that modulate functions of cells other than those of the immune system. Their role in the pathogenesis of alopecia areata (AA) and universalis (AU) has not been explored. This study is an investigation of the function of peripheral blood monocytes from normal subjects and patients with AA, AU, and alopecia totalis (AT), with respect to the principal macrophage-derived angiogenic factor, tumor necrosis factor alpha (TNF alpha). Because neovascularization is a necessary component in the anagen phase of hair growth and may play a role in the pathology of these disorders, we asked whether monocyte/macrophage angiogenic activity was compromised in these alopecias. Purified preparations of monocytes were activated in culture. Conditioned media were assessed for angiogenic activity on the chick chorioallantoic membrane and for concentration of TNF alpha by enzyme-linked immunosorbent assay (ELISA). Both angiogenic and the TNF concentration were significantly diminished in conditioned media from AU monocytes when compared to those from normal subjects and patients with AA. These results show that the function of AU monocytes may be abnormal and that the abnormality may distinguish AU from AA. Defective monocyte/macrophage function could also play a pathogenic role via effects on neovascularization and/or modulation of the immune response. | 18 |
The role of low-dose chemotherapy in myelodysplastic syndromes. Aggressive chemotherapy of myelodysplastic syndromes is rarely feasible because these disorders predominantly occur in elderly patients who often have concurrent illnesses. Alternative treatment modalities must therefore be evaluated. This review summarizes the results that have been obtained with low-dose chemotherapy, especially with low-dose cytosine arabinoside (Ara-C). Overall response rates to treatment with low-dose Ara-C are about 40%, with some 20% of patients achieving a complete remission. Transition of MDS to AML does not reduce the probability of response. The therapeutic outcome cannot be reliably predicted by clinical or experimental parameters. Hematological toxicity is substantial, with approximately 10-25% treatment-related deaths. Duration of response is short and rarely exceeds one year. In terms of overall survival, low dose Ara-C does not appear to be superior to supportive care only. Other cytotoxic agents have not been studied in detail, but data available do not suggest an appreciable advantage over Ara-C. Before denying low-dose chemotherapy a helpful role in MDS, randomized studies should concentrate on those patients who can be expected to derive the greatest benefit. Because of their short survival, patients with RAEBt or those transformed to overt leukemia are such candidates. | 14 |
Smoking and mortality among older men and women in three communities. Although cigarette smoking is the leading avoidable cause of premature death in middle age, some have claimed that no association is present among older persons. We prospectively examined the relation of cigarette-smoking habits with mortality from all causes, cardiovascular causes, and cancer among 7178 persons 65 years of age or older without a history of myocardial infarction, stroke, or cancer who lived in one of three communities: East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. At the time of the initial interview, prevalence rates of smoking in the three communities ranged from 5.2 to 17.8 percent among women and from 14.2 to 25.8 percent among men. During five years of follow-up there were 1442 deaths, 729 due to cardiovascular disease and 316 due to cancer. In both sexes, rates of total mortality among current smokers were twice what they were among participants who had never smoked. Relative risks, as adjusted for age and community, were 2.1 among the men (95 percent confidence interval, 1.7 to 2.7) and 1.8 among the women (95 percent confidence interval, 1.4 to 2.4). Current smokers had higher rates of cardiovascular mortality than those who had never smoked (as adjusted for age and community, the relative risk was 2.0 [95 percent confidence interval, 1.4 to 2.9] among the men and 1.6 [95 percent confidence interval, 1.1 to 2.3] among the women), as well as increased rates of cancer mortality (relative risk, 2.4 [95 percent confidence interval, 1.4 to 4.1] among the men and 2.4 [95 percent confidence interval, 1.4 to 3.9] among the women). In both sexes, former smokers had rates of cardiovascular mortality similar to those of the participants who had never smoked, regardless of age at cessation, whereas the rates for all cancers, as well as smoking-related cancers, remained elevated among men who had once smoked. Our prospective findings indicate that the mortality hazards of smoking extend well into later life, and suggest that cessation will continue to improve life expectancy in older people. | 20 |
Development of intrapancreatic abscess--a consequence of CMV pancreatitis? Cytomegalovirus (CMV) pancreatitis was diagnosed in eight out of 124 pancreatic transplant recipients. Five of the eight patients developed intrapancreatic abscesses and four of the grafts were lost, but one is still functioning. In the three additional cases of pancreatitis, antiviral treatment with foscarnet or ganciclovir was given as soon as signs of CMV pancreatitis were detected. No such grafts were lost during the acute phase. CMV infection was diagnosed in cells from pancreatic juice, by virus isolation, detection of CMV antigen in cells from pancreatic juice or by CMV serology. The signs and symptoms of CMV pancreatitis included fever, general malaise, abdominal pain, diarrhoea, localized peritonitis, hyperamylasaemia, leukopenia and hyperglycaemia. It is recommended that rapid diagnostic procedures for CMV should be carried out when early signs of pancreatitis develop in pancreatic graft recipients. Antiviral treatment should be given when CMV pancreatitis is suspected or diagnosed in order to prevent the development of intrapancreatic abscesses and graft loss. | 15 |
Enolase is present at the centrosome of HeLa cells. Antibodies raised against the C-terminus and N-terminus region of gamma gamma enolase, as well as a polyclonal antibody raised against bovine brain gamma gamma enolase, were used to study the distribution of this glycolytic enzyme during the cell cycle in HeLa cells. Enolase was found to be present throughout the cytoplasm of both interphase and dividing cells. In addition, a portion of cellular enolase was detected at the centrosome throughout the cell cycle. The capacity of glycolytic enzymes to play a structural as well as a glycolytic role suggests that the presence of enolase at the centrosome may be correlated with the organization of both the interphase cytoskeleton and the mitotic spindle. | 17 |
Effect of subcutaneous administration of recombinant human erythropoietin on plasma protein C, protein S, and antithrombin III levels in patients on continuous ambulatory peritoneal dialysis. The effect of subcutaneous administration of recombinant human erythropoietin (rHuEPO) on plasma natural coagulation inhibitors (protein C, protein S, and antithrombin III) was evaluated in 10 uremic patients on continuous ambulatory peritoneal dialysis (CAPD). These patients were commenced on a 16 week-course of twice weekly rHuEPO by the subcutaneous route. The hemoglobin increased significantly from 6.9 +/- 1.3 g/dl to 9.6 +/- 1.9 g/dl after subcutaneous rHuEPO treatment (p less than 0.01) at an average dose of 84 +/- 9 U/kg body wt/week. With rHuEPO therapy, a significant increase in platelet counts was observed, albeit within the normal range. A significant increase in the prothrombin time was demonstrated at 6 weeks after treatment and increased activated partial thromboplastin time was observed at 6 weeks and 16 weeks after rHuEPO administration although these measurements still remained in normal range. CAPD patients have comparable or even higher plasma levels of natural coagulation inhibitors compared with healthy controls supporting our previous findings that patients on CAPD have normal plasma levels due to an effective compensatory production despite peritoneal losses of these proteins with CAPD. No change in either the immunological or the functional activity of these natural coagulation inhibitors was demonstrated with rHuEPO therapy and clinical thrombosis was not observed during and after rHuEPO therapy. We conclude that there is no laboratory evidence of increased risk of thrombogenesis due to reduction of natural coagulation inhibitors with rHuEPO therapy. | 21 |
Effects of cyclic adenosine 3':5'-monophosphate and related agents on acid secretion by isolated rabbit gastric mucosa. The effects of various adenosine phosphate compounds, theophylline, histamine,a nd metiamide, on steady rates of acid secretion by isolated fundic mucosa of the rabbit were measured by the pH stat method. Cyclic adenosine 3':5'-monophosphate (cyclic AMP), N(6), O(2')-dibutyryl adenosine 3':5'-monophosphate and theophylline increased the rate of acid secretion. Addition of theophylline in a concentration which has no stimulatory effect, reduces the effective concentrations cyclic AMP or histamine required for stimulation of acid secretion. Measurements of lactate, pyruvate, and CO2 appearances indicated that the increases in acid secretory rates were predominantly due to H+ and not organic acid accumulation in the luminal bath-secretion. Metiamide prevented the stimulatory effects of histamine and ATP. However, metiamide did not prevent the stimulatory effects of N(6),9(2')-dibutyryl adenosine 3':5'-monophosphate, theophylline, or 5'-AMP. The results provide further evidence for a role of cyclic AMP in governing the rate of acid secretion by rabbit stomach. The data also are consistent with histamine and ATP (at least in the concentration used) requiring adenylate cyclase activity for stimulation of acid secretion and 5'-AMP inhibiting phosphodiesterase activity. | 19 |
Electrotransformation of intact cells of Brevibacterium flavum MJ-233. Electroporation allowed transformation of intact cells of Brevibacterium flavum MJ-233. The two plasmids used for electroporation were pCRY2 (6.3 kilobase) and pCRY3 (8.2 kilobases). Both plasmids contain the chloramphenicol-resistance gene and the autonomous replication origin in B. flavum MJ-233. The efficiency of electrotransformation was optimal with cells harvested at the middle log phase of growth, and was improved by the addition of 1.0 U/ml of penicillin G to the culture medium. The optimum yield of transformants per micrograms DNA was 5 x 10(4) when the cell suspension was pulsed at a cell density of 1 x 10(10)/ml and at a DNA amount of 1.0 micrograms. | 14 |
Marine biosurfactants, II. Production and characterization of an anionic trehalose tetraester from the marine bacterium Arthrobacter sp. EK 1. Within a screening for biosurfactants we could isolate various n-alkanes utilizing marine bacteria which were capable of synthesizing glycolipids. One strain was identified as Arthrobacter sp. EK 1 which produced trehalose lipids. After purification by column and thick layer chromatography the main fraction, an anionic 2,3,4,2'-trehalose tetraester, was obtained. The chain lengths of fatty acids ranged from 8 up to 14, furthermore succinate could be detected. Since the place of substitution of succinate has so far not been cited in literature, a definitive structural elucidation was carried out chemically by hydroboration and by 1H, 2D1H, 13C and 13C-1H correlation NMR measurements. All investigations confirmed the exact position of succinate at C 2 atom of trehalose. After improvement of growth conditions the production of the trehalose tetraester increased up to 4.8 milligrams during a fermentation in 20 l bioreactor under nitrogen limitation. | 14 |
[Correlation of wall thickness and the luminal diameter of the arterial vessels of the kidneys in hypertension]. The autopsy material was used to study the ratio of the wall thickness and the lumen diameter in arch and interlobular arteries and arterioles of the kidneys in patients with hypertension and in the control group. A statistical analysis revealed in interlobular arteries and arterioles of the age group of 30-49 years a slight but a significant shift of the parameter under study towards more severe degrees of involvement. This was confirmed by the frequency of different degrees of damage. No significant differences in changes observed in interlobular arteries and arterioles were found. This method is recommended for the study of the structural changes of intrarenal arteries. | 16 |
First clinical implantation of the BCM 3.5 ventricular assist device (VAD). We report on the first human implantation of the BCM 3.5 ventricular assist device in a 46-year-old man suffering from terminal stage cardiomyopathy. The circulatory support was used as a bridge to heart transplantation. The patient was in cardiogenic shock and was on assisted circulation for 18 days after which he underwent cardiac transplantation. While receiving support from the ventricular assist device, the patient's condition improved remarkably and 50 days after transplantation he was discharged from hospital. We give a detailed description of the surgical technique, with special emphasis on the procedures for air extraction. We describe the evolution of the hemodynamic status before and after implantation. Final inspection of the device and cannulae after removal showed no thrombi and only small fibrin deposits in the membrane-wall junction. | 14 |
Detection of histamine release inhibitory factor- and histamine releasing factor-like activities in bronchoalveolar lavage fluids. Histamine releasing factors (HRF) are a group of cytokines that cause degranulation of basophils and mast cells. Recently we have described a histamine release inhibitory factor (HRIF) that inhibits HRF-induced histamine release from basophils and mast cells. The objective of this study was to investigate the presence of these cytokines in bronchoalveolar lavage (BAL) fluid from normal subjects. We found that BAL fluids from 12 to 17 volunteers contained a dialyzable (molecular weight cutoff 3500) factor that inhibited basophil histamine release by HRF, anti-IgE, concanavalin A, and N-formyl-methionyl-leucyl-phenylalanine (FMLP). In addition, BAL fluids from 83% of the tested donors contained a nondialyzable inhibitor that blocked HRF-induced histamine release from basophils. The molecular weight of this inhibitor was estimated to be 20 to 30 and 8 to 10 kD by Sephadex G-50 chromatography and TSK 2000 size-exclusion HPLC. None of the unconcentrated BAL fluids showed any HRF activity on initial screening using basophils from allergic subjects. However, when the BAL fluids were concentrated, all BAL samples that were tested (N = 10) demonstrated significant HRF activity. The molecular weight of BAL HRF has been estimated to be in the range of 15 to 25 kD by size-exclusion HPLC, similar to the HRF synthesized by mononuclear cells. Thus we have demonstrated the presence of both HRF and HRIF in the BAL fluids. We speculate that these cytokines may be involved in the local regulation of basophil and mast cell activation. | 15 |
Diagnostic perceptions and diagnostic behavior in a family practice unit. Results of a pilot study with nine physicians in a model Family Practice Unit are described in this report. It was hypothesized that decisions regarding treatment priorities would lead to the "undertreatment" of ailments for which the physicians felt relatively ineffective and that feelings of efficacy would be greater for primarily organic than for primarily psychological ailments. Physician interviews and examination of the Unit's diagnostic file provided the data for this study. A treatment bias as a function of the degree to which an ailment had a psychological compenent was not demonstrated. However, the physicians did feel less effective (less comfortable) in treating problems that were significantly psychological and also felt that methods of intervention for such ailments were less clear-cut. Physician comfort level was greater when there were few alternative treatment methods generally used for the ailment and when the ailment was recorded frequently. A suggestion is made that medical curricula include more practical experience in treating ailments which have notable psychological components in order to increase physician comfort and probably physician effectiveness. | 17 |
Mammographic follow-up of nonpalpable low-suspicion breast abnormalities: one versus two views. A retrospective study involving 498 women with a total of 666 breast lesions was undertaken to determine the relative efficacy of one- and two-view mammography in the follow-up evaluation of "low-suspicion" abnormal mammographic findings. These abnormalities consisted of well-defined masses (47.1%), well-defined punctate microcalcifications (20.9%), and parenchymal asymmetry (32.0%). Confidence in the adequacy of the single-view follow-up was high in 91% of cases. The addition of the second mammographic view changed the one-view interpretation in approximately 1% of all cases. Two cancers were detected during the initial follow-up period. Both cancers were detected with single-view and standard two-view follow-up examinations, with high confidence. In this controlled retrospective study, the single-view follow-up examination was adequate for follow-up of most low-suspicion mammographic abnormalities. Monitoring by physicians, however, would be necessary to prevent an unacceptable number of patient recalls, which could make the one-view follow-up study impractical to use in some practices. | 15 |
[Absorbable suture material in the surgery of the biliary tract (author's transl)]. Conventional unabsorbable suture material can lead to gall salt precipitation and thus to gall stone formation. Catgut segments may cause identical sequelae if they are displaced into the lumen of the biliary tract under certain conditions. The reaction of polyglycolic acid (PGA) as well as of polyglactin material was tested under in-vitro conditions. PGA material disintegrated within 9 weeks; precipitation of gall salts was not observed. Polyglactin samples showed stable durability up to 22 weeks under the same conditions; firmly adherent small concrements could be demonstrated. In accordance with these observations, PGA material seems to be the most appropriate suture material for the surgery of the biliary tract at the time being. | 14 |
[Role of the liver in optimization of the thyroid status of rats in hypothyrosis caused by irradiation]. Experiments were made on 100 random bred rats of various age groups, controls and animals exposed to single external gamma-radiation at a dose of 1 Gy on the 35th day of life. Thyroxine and triiodothyronine concentrations were investigated in peripheral blood and separately in arterial blood, in thyroid, portal and hepatic venous blood. The activity of T4 conversion into T3 by 5'-deiodinating enzymes of the liver microsomal fractions and the activity of the liver mitochondrial enzymes--cytochrome of C-oxidase and alpha-glycerophosphate dehydrogenase were also investigated. A decrease in thyroid excretion of T4 and T3 and T4 blood concentration was noted in rats exposed to irradiation. 5'-thyroxine deiodinating activity of the microsomal enzymes was elevated in the liver of such rats; a T3 ratio in the blood outflowing from the liver was on the increase. A conclusion has been made that 5'-deiodination in the liver of rats with postradiation hypothyrosis is effected as a result of increased production of the most active hormone T3 from less active T4. | 18 |
Engineering of papain: selective alteration of substrate specificity by site-directed mutagenesis. The S2 subsite specificity of the plant protease papain has been altered to resemble that of mammalian cathepsin B by site-directed mutagenesis. On the basis of amino acid sequence alignments for papain and cathepsin B, a double mutant (Val133Ala/Ser205Glu) was produced where Val133 and Ser205 are replaced by Ala and Glu, respectively, as well as a triple mutant (Val133Ala/Val157Gly/Ser205Glu), where Val157 is also replaced by Gly. Three synthetic substrates were used for the kinetic characterization of the mutants, as well as wild-type papain and cathepsin B: CBZ-Phe-Arg-MCA, CBZ-Arg-Arg-MCA, and CBZ-Cit-Arg-MCA. The ratio of kcat/KM obtained by using CBZ-Phe-Arg-MCA as substrate over that obtained with CBZ-Arg-Arg-MCA is 8.0 for the Val133Ala/Ser205Glu variant, while the equivalent values for wild-type papain and cathepsin B are 904 and 3.6, respectively. This change in specificity has been achieved by replacing only two amino acids out of a total of 212 in papain and with little loss in overall enzyme activity. However, further replacement of Val157 by Gly as in Val133Ala/Val157Gly/Ser205Glu causes an important decrease in activity, although the enzyme still displays a cathepsin B like substrate specificity. In addition, the pH dependence of activity for the Val133Ala/Ser205Glu variant compares well with that of cathepsin B. In particular, the activity toward CBZ-Arg-Arg-MCA is modulated by a group with a pKa of 5.51, a behavior that is also encountered in the case of cathepsin B but is absent with papain.(ABSTRACT TRUNCATED AT 250 WORDS) | 17 |
Surgical treatment of hydatid disease of the liver. A 20-year experience. The medical records of 135 consecutive patients (74 women and 61 men) who underwent surgery for hydatid liver disease were reviewed. The patients ranged in age from 4 to 81 years. Twenty-seven patients had undergone previous surgery for hydatid liver disease. Cysts were solitary in 100 patients and multiple in 35 patients. Seventeen patients had concomitant extrahepatic disease. Conservative procedures were used in 71 patients (capitonnage in 50 patients and partial pericystectomy in 21 patients). Radical procedures were used in 64 patients (total pericystectomy in 35 patients, subtotal pericystectomy in 16 patients, and wedge or major liver resection in 13 patients). Operative mortality was 2.2% and morbidity rate was 23.7%. Recurrent disease was found in 13 patients at a mean interval of 3 years from the first operation. Better short- and long-term results were obtained with the use of radical procedures. | 10 |
[Results of 8 years' research on the toxicologic evaluation of animal food additives by the so-called relay toxicity method]. The authors report the underlying principles of the new methodological approach called "relay toxicity" which they proposed eight years ago for the toxicological evaluation of animal feed additives. They stress its value either as a possible criterion of rejection or as a criterion of acceptability. In the latter case, the limiting factor is the difficulty of applying an adequate safety factor when food products destined for human consumption and obtained from animals receiving the additives to be evaluated are administered to laboratory animals. Amongst the examples of the additives which have been subjected to toxicological evaluation using the authors' new method, the following are examined: as growth factor, carbadox, anabolising agents and, in particular, diethylstilboestrol, and steroids used as egglaying potentializers. The results obtained are discussed. | 20 |
Antimicrobial gentamicin activity in the presence of exogenous protease inhibitor (Bowman-Birk inhibitor) in gentamicin-induced nephrotoxicity in rats. In our previous studies, we found increased levels of urinary trypsin inhibitory activity in gentamicin-induced nephrotoxicity in rats. Following administration of the Bowman-Birk trypsin and chymotrypsin inhibitor (BBI), no proteinuria was detected in gentamicin-treated rats, and a decrease in creatinine clearance was noted in only 50% of the injected rats. In the present study, we examined the antimicrobial activity of gentamicin against Escherichia coli in the presence of BBI in gentamicin-induced nephrotoxicity in rats. We found that 50% of rats with E. coli-positive blood cultures died of septicemia. All the rats injected with E. coli plus gentamicin or E. coli plus gentamicin plus BBI survived, the latter showing no proteinuria or deterioration in creatinine clearance. In conclusion, BBI, which is an effective inhibitor of gentamicin-induced nephrotoxicity, does not affect the antimicrobial activity of gentamicin sulfate. | 18 |
Effect of thyroxine treatment on carnitine levels in mice. The effect in mice of 8 subcutaneous injections of 20 microgram of L-thyroxine at 12 hr-intervals on the carnitine concentration in the heart and skeletal muscle tissue was studied. In skeletal muscle tissue, the thyroxine treatment resulted in a depressed carnitine concentration. The mean values were 1.59 +/- 0.034 (S.E.M.) and 2.03 +/- 0.045 mumol/g noncollagen protein and 1.11 +/- 0.035 and 1.45 +/- 0.037 mumol/g dry weight for the thyroxine treated and the control animals, respectively. Thyroxine produced myocardial hypertrophy. The thyroxine treated animals had lower cardiac values when dry weight was used as reference base 4.17 +/- 0.10 mumol/g dry weight than the control group, 4.69 +/- 0.18 mumol/g dry weight. No statistically significant difference was found between the two groups when the cardiac carnitine concentration was expressed per g noncollagen protein or as carnitine in the entire hearts. Thus, thyroxine has been showed to influence the metabolism of carnitine in mice. | 12 |
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