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7788793
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Determining one or more change points.
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A statistical method is presented for determining whether a line has one or more change points at unknown locations. A change point is a point where a line suddenly changes its slope but is continuous, i.e. it does not jump. Change points are also referred to as break points or join points. A step-wise procedure is suggested which starts by fitting a straight line without points. Next a line with a single change point is fit to the data, and a statistical test is used to determine if the line with a single change point provides a significantly better fit to the data than the line with no change points. This can then be followed by fitting a line with two change points, etc. The problem of determining the number of change points that best fits the data is discussed. A modified version of Akaike's information criterion (AIC) is used to select the best number of change points to avoid over fitting. An example of fluorescence anisotropy measurements of the total phospholipid from the liver of a marine fish as a function of temperature is presented.
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7788735
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[Expression of c-erbB-2 protein and EGF receptor in hepatitis B, cirrhosis and hepatocellular carcinoma].
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The expressions of c-erbB-2 oncogene and epidermal growth factor receptor (EGFR) were investigated immunohistochemically in specimens from 184 cases of hepatitis B, cirrhosis and hepatocellular carcinoma (HCC) and 29 normal liver specimens. EGFR was expressed in 36% (48/134) of the hepatocellular carcinoma and chronic liver disorder specimens and it was immunolocalized mainly in the sinusoidal endothelial cells. No significant difference was found between EGFR expression in HCC and in benign chronic liver disorders. These results indicate that EGFR may have some role in the proliferation of the sinusoidal epithelial cells in chronic liver disease. Low level c-erbB-2 expression was observed in 5/29 (17%) of normal liver specimens. In chronic hepatitis B and liver cirrhosis, its expression was found in all specimens. c-erbB-2 protein was immunolocalized mainly in small polygonal liver cells (SPLCs) and hepatocytes in small-cell dysplasia (SCD) and in ductular metaplasia (DM); c-erbB-2 expression in HCC cells was found to be weaker than in SPLCs, the hepatocytes in SCD and in DM. These results indicate that activated c-erbB-2 oncogene may have a role in human HCC genesis through promoting the development of SCD from SPLC proliferation and the progression of SCD. The close relation between the expression of c-erbB-2 and HBxAg imply that the activation of c-erbB-2 in human liver tissues may be related to HBV X gene.
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7788734
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[The relationship of intraacinar pulmonary arterial structural remodelling with pulmonary hypertension].
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Pulmonary hypertension (PHT) was induced in rats by a single subcutaneous injection of monocrotaline (MCT). Light and electron microscopy, immunohistochemistry and morphometry were applied to investigate the different pathological changes of the intraacinar pulmonary arteries (IAPA) and their relationship with PHT. The results showed that pulmonary function was related to the morphological structure and indicated that the remodelling in the IAPA structure was the pathological basis of PHT. The results further suggested that the proliferation and myoid differentiation of the pericyte play an important role in the muscularization of the nonmuscular pulmonary artery in IAPA.
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7788733
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[Tuberculous lymphadenitis: a sarcoidosis-like variation].
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By means of polymerase chain reaction technique to amplify DNA sequence specific for mycobacterium tuberculosis (M. TB-PCR), BCG immunohistochemistry (BCG-IHC) as well as acid fast stain (AF), mycobacterium other than tuberculosis (MOTT) and mycobacterium tuberculosis (M. TB) were detected in paraffin blocks from 12 cases diagnosed by consultant pathologists as lymph node "sarcoidosis". Of the 5 cases which consulting pathologists unanimously agreed to the lymph node "sarcoidosis" diagnosis, 1 case showed BCG-IHC (+) and M. TB-PCR (+); Of the 7 cases which most of the consulting pathologists agreed to be "sarcoidosis", 1 case showed AF (+), BCG-IHC (+) and M. TB-PCR (+). The results suggest: (1) some tuberculous lymphadenitis cases may present as "sarcoidosis"-like lesions; (2) lymph node sarcoidosis may be related to MOTT and M. TB infection.
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7788732
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[Congenital pulmonary lymphangiectasis].
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Six rare cases of congenital pulmonary lymphangiectasis were presented. The macroscopic characteristic of the lungs was honeycomb appearance due to extreme dilatation of the lymphatic spaces in the subpleural, interlobular, peribronchial and perivascular connective tissue. They had thin walls lined by endothelium. The dilated lymphatics may be due to congenital developmental defects or obstruction of major lymphatics, but they appeared to be associated only with pulmonary venous hypertension.
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7788731
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[Detection of the apoptosis-suppressing oncoprotein bcl-2 in ameloblastomas].
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The product of apoptosis-suppressing oncoprotein bcl-2 can block apoptosis and result in the development of tumors. In this study, the expression of bcl-2 was observed in 40 cases of ameloblastomas by immunohistochemical staining. The results showed that the epithelium and reduced enamel epithelium of the enamel organ, the odontoblasts, basal cells of odontogenic cysts, normal oral epithelium and 90% (36/40) of ameloblastomas were positive for bcl-2, indicating that the expression of bcl-2 in odontogenic epithelium may be related to the degree of differentiation and proliferation of cells, the overexpression of bcl-2 may be associated with the development of ameloblastoma.
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7788730
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[Transferrin receptor and iron deposition pattern in the hepatic lobules of the iron-deficient and iron-overloaded rats].
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Wistar rats were made iron deficient by a low iron regimen. Iron overload was produced by repeated intraperitoneal injections of ferric nitrilotriacetate (Fe(3+)-NTA) for one to four months. Hepatic tissues from these iron deficient, overloaded and control rats were examined for transferrin receptor (TfR), transferrin (Tf) and iron after immunohistochemical staining. TfR and Tf were mainly distributed in the peripheral part of the lobule (zone 1) in the normal, iron deficient and iron-overloaded rats. The staining intensity decreased from zone 1 to zone 3. The staining intensity of TfR was strongest in iron-deficiency rat hepatic cells, weakest in iron-overloaded rat hepatic cells when compared with controls. The difference of Tf staining between the three groups of rats was similar to that of TfR. In the iron-overloaded rats, the staining intensity of iron was stronger in zone 1 than in zone 2 and 3, similar to the distribution pattern of TfR and Tf. These findings suggest that (1) iron uptake in hepatic cells in vivo is regulated and mediated by TfR and Tf, (2) the expression pattern of TfR and Tf in zone 1 to zone 3 liver cells may result in the progressive decrease of iron deposition in the hepatic lobules of the iron overloaded rats.
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7788729
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[Malignant rhabdoid tumor of kidney: a clinicopathologic and immunohistochemical study of 15 patients].
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The clinical and pathological features of 15 infants with malignant rhabdoid tumors of kidney are presented. These tumors were identified among 391 primary renal neoplasms in this hospital. The male/female ratio was 2.8:1.0, mean age at diagnosis was 18 months with a range from 4 to 55 months. Of the 10 patients with follow-up records, 8 have died, 2 were alive and free of disease 15 and 55 months after the diagnosis respectively. A wide histologic spectrum was encountered. All tumors exhibited classical morphology in at least some areas, characterized by solid proliferation of monotonous tumor cells with vesicular nuclei and prominent nucleoli, abundant cytoplasm and intracytoplasmic inclusions. Immunohistochemical studies were performed in all 15 cases. Vimentin was positive in all tumors, ENA in 12, cytokeratin in 8, desmin in 2 and myoglobin in one. All cases were negative for presence of lysozyme, NSE and neurofilament. Our results show that this tumor is a distinctive and highly malignant neoplasm of the infant kidney with considerable morphological and immunohistochemical diverse phenotypes.
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7788728
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[Expression of Epstein-Barr virus encoded small RNA-1 and latent membrane protein-1 in midline T-cell lymphomas].
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Nine cases of midline T-cell lymphoma (MTL) were studied for expression of Epstein-Barr virus (EBV) encoded small RNA-1 (EBER-1) and EBV latent membrane protein-1 (LMP-1) using in situ hybridization and immunohistochemistry respectively. EBER-1 was detected in nuclei of tumor cells in 8/9 cases of MTL and LMP-1 was found on membrane and in cytoplasm of tumor cells in 7/9 cases of MTL. The results show: (1) There is a strong association between EBV and MTL. EBV may play an important role in the pathogenesis of MTL. (2) The detection frequency of EBV in MTL is higher than peripheral T-cell lymphoma from other sites of the body. (3) EBER-1 in situ hybridization and LMP-1 immunohistochemistry are sensitive and reliable in detection of EBV in MTL and the latter is more economic and convenient.
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7788724
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The mcm2-1 mutation of yeast causes DNA damage with a RAD9 requirement for repair.
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The minichromosome maintenance mutation, mcm2-1, has been found to synthesize damaged DNA at 35 degrees C. Growth at this temperature rendered the mutant strain more sensitive to killing by ultraviolet irradiation. DNA damage could also be detected by pulsed-field gel electrophoresis, where a higher fraction of the DNA loaded was retained in the inserts at the wells. During the exponential phase of growth at this temperature about 50% of the cells had large buds, with the nucleus at or near the neck of the bud in most cases. The incorporation of the rad9 deletion in the mcm2-1-carrying strain caused a reduction in the percentage of large-budded cells and a moderate loss of cell viability. The results are consistent with mcm2-1 causing DNA damage leading to the arrest of cells in the S/G2 phase of the cell cycle, which was partially dependent on the RAD9 gene product.
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7788727
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[A comparison between astrocytoma cells and the developing astrocytes in human embryo brain by electron microscopy].
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60 cases of astrocytoma of brain and 8 human embryo brains were studied with light and electron microscopy. The 5 types of tumor cells in astrocytoma include the undifferentiated, pre-astrocyte, astrocyte gemistocyte and tumor giant cells. Some similarities were found between the ultrastructure of astrocytoma and that of the developing astrocyte, the tumor cells somewhat resembling the cells of developing astrocytes. But certain differences were observed, the tumor cells were usually polymorphic with increased chromatin in nucleus, and asynchronism between nucleus and cytoplasm differentiation was sometimes found. The current nomenclature and classification of astrocytoma were evaluated and discussed, the author's opinion on classification was presented.
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7788723
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Calmodulin-dependent protein kinase II and calmodulin are required for induced thermotolerance in Saccharomyces cerevisiae.
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We show here that yeast mutants lacking calmodulin-dependent protein kinase II fail to fully acquire induced thermotolerance. A similar result was also obtained with mutants depending solely on either the N-terminal half or the C-terminal half of calmodulin. These findings indicate that both calmodulin-dependent protein kinase II and calmodulin are required for induced thermotolerance.
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7788722
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The rps3-rpl16-nad3-rps12 gene cluster in rice mitochondrial DNA is transcribed from alternative promoters.
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The two gene clusters rps3-rpl16 and nad3-rps12 are separated from each other in the mitochondrial genome and are expressed as the individual transcription units in many plants. In rice mitochondrial DNA (mtDNA), the four genes rps3, rpl16, nad3 and rps12 are located within a region of 6 kbp. Northern-blot analysis revealed that a large transcript (6.6 kb) hybridized to both the rps3-rpl16 and the nad3-rps12 gene clusters. Using RT-PCR, we amplified a fragment of anticipated size (790 bp) from two primers that corresponded to sequences in the coding regions of rpl16 and nad3, demonstrating that at least two of the four genes, namely rpl16 and nad3, were co-transcribed. These results together indicated that all four genes, namely, rps3, rpl16, nad3 and rps12, were co-transcribed in rice mitochondria. Transcription initiation sites were determined by an in vitro capping/ribonuclease protection assay and primer extension analysis. Two initiation sites were identified in the rps3-rpl16-nad3-rps12 gene cluster: one was located upstream of rps3 and the other was located between rpl16 and nad3. This evidence indicates that the rps3-rpl16-nad3-rps12 gene cluster is transcribed from two alternative promoters.
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7788721
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In vitro self-splicing reactions of chloroplast and mitochondrial group-I introns in Chlamydomonas eugametos and Chlamydomonas moewusii.
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The self-splicing activity of nine chloroplast group-I introns (CeLSU.1 to CeLSU.6, CepsbC.1, CepsbC.2 and CmpsaB.1) and of one mitochondrial group-I intron (CmmtLSU.1) from the interfertile green algae Chlamydomonas eugametos and C. moewusii was examined using RNA templates produced by in vitro transcription of cloned DNA sequences. All introns, with the exception of the mobile intron CeLSU.5 encoding the site-specific I-CeuI endonuclease, were found to catalyze their own splicing in the absence of proteins. The introns that proved to be the best substrates under the conditions employed are CeLSU.1, CeLSU.3, CeLSU.4, CepsbC.1 and CmmtLSU.1. The implications of our results for the origin and spread of group-I introns in the organellar genomes of green algae are discussed.
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7788720
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A group-I intron in the mitochondrial small subunit ribosomal RNA gene of Sclerotinia sclerotiorum.
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A 1,380-bp intervening sequence within the mitochondrial small subunit ribosomal RNA (mt SSU rRNA) gene of the fungus Sclerotinia sclerotiorum has been sequenced and identified as a group-I intron. This is the first report of an intron in the mt SSU rRNA gene. The intron shows close similarity in secondary structure to the subgroup-IC2 introns from Podospora (ND3i1, ND5i2, and COIi5) and Neurospora (ND5i1). The intron has an open reading frame (ORF) that encodes a putative protein of 420 amino acids which contains two copies of the LAGLI-DADG motif. The ORF belongs to a family of ORFs identified in Podospora (ND3i1, ND4Li1, ND4Li2, ND5i2, and COIi5) and Neurospora (ND5i1). The putative 420-aa polypeptide is also similar to a site-specific endonuclease in the chloroplast large subunit ribosomal RNA (LSU rRNA) gene of the green alga Chlamydomonas eugametos. In each clone of S. sclerotiorum examined, including several clones which were sampled over a 3-year period from geographically separated sites, all isolates either had the intron or lacked the intron within the mt SSU rRNA gene. Screening by means of Southern hybridization and PCR amplification detected the intron in the mt SSU rRNA genes of S. minor, S. trifoliorum and Sclerotium cepivorum, but not in other members of the Sclerotiniaceae, such as Botrytis anamorphs of Botryotinia spp., or in other ascomycetous and basidiomycetous fungi.
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7788719
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Molecular cloning and sequence analysis of the scpZ gene encoding the serine carboxypeptidase of Absidia zychae.
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Carboxypeptidase Z is a serine carboxypeptidase secreted by Absidia zychae NRIC 1199. The cDNA and genomic DNA carrying the scpZ gene encoding carboxypeptidase Z were cloned and sequenced. The nucleotide sequences of the cDNA (1.4 kb) and the genomic DNA (3.3 kb) were analyzed and the intervening sequences were located by a comparison of the two. It was found that the scpZ gene was interrupted by 11 short introns, 50-75 nucleotides in length. Genomic Southern analysis showed that there was only one scpZ gene in the genome of A. zychae. The gene encoded a putative pre-pro-enzyme composed of 409 amino-acid residues of the mature carboxypeptidase Z (M(r) 45,421) and an additional N-terminal sequence of 51 amino-acid residues. The amino-acid sequence around the active serine residue of carboxypeptidase Z (-G-E-S-Y-G-G-) differed from the consensus (-G-E-S-Y-A-G-) which is conserved in most of the serine carboxypeptidases so far analyzed.
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7788718
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Molecular cloning and analysis of nre, the major nitrogen regulatory gene of Penicillium chrysogenum.
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We have isolated the Penicillium chrysogenum nre gene which is homologous to the major nitrogen regulatory genes areA from Aspergillus nidulans and nit-2 from Neurospora crassa. Overall, nre shows 60% identity to areA and 30% identity to nit-2 at the amino-acid level. The gene encodes a protein of 835 amino-acid residues and contains a single Cys2/Cys2-type zinc finger with an adjacent basic region and a putative acidic activation region. In the DNA-binding domain, 98% of the amino-acid residues are identical in nre, areA and nit-2. The nre gene has been shown to be functional in N. crassa by heterologous complementation of a nit-2 mutant. Growth tests indicated that transformants could utilize nitrate, amino-acids, purines and amides as sole nitrogen sources. Nitrate reductase activity assays performed with transformants demonstrated that nitrogen control was completely normal. Complementation of N. crassa nit-2 mutants with 5'-deletion clones of nre suggests the possible presence of an internal promoter within the coding region. Northern analysis and ribonuclease protection assays of total cellular RNA indicated that nre encodes a 3.2-kb transcript which is reduced in content under conditions of nitrogen repression.
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7788717
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Sequence analysis of the Aspergillus nidulans pectate lyase pelA gene and evidence for binding of promoter regions to CREA, a regulator of carbon catabolite repression.
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The nucleic acid and deduced amino-acid sequences of the pectate lyase gene (pelA) from Aspergillus nidulans are presented. The pelA gene contains two short introns, 68 and 49 bp in length, and encodes a peptide of 326 amino acids. Five transcriptional start sites are clustered between 65 and 79 bp upstream of the start codon as determined by primer extension. Comparison of the amino-acid sequences of pectate or pectin lyases from bacteria, fungi and plants revealed less than 30% overall identity. However, five regions within these enzymes, in particular domains associated with the active site, are highly conserved with amino-acid similarities greater than 50%. Phylogenetic analysis using the principle of parsimony (PAUP 3.1.1) showed that pelA is most closely related to pectate lyases from plants rather than pectin lyases from other fungi. Previously, pelA was shown to be induced by polygalacturonic acid and repressed in the presence of preferred carbon sources, such as glucose. Gel mobility shift analysis indicates that a PstI-SphI fragment from the pelA promoter binds to a fusion protein composed of the N-terminal part of CREA, a protein involved in carbon catabolite repression, and glutathione-S-transferase. This result suggests CREA may contribute to the regulation of pelA expression.
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7788716
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Expression cloning, purification and characterization of a beta-1,4-galactanase from Aspergillus aculeatus.
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Expression cloning has been used to isolate a cDNA encoding beta-1,4-galactanase from the filamentous fungus Aspergillus aculeatus. A cDNA library was prepared from mycelia, inserted in a yeast expression vector and transformed into Saccharomyces cerevisiae. Thirteen clones secreting galactanase activity were identified from a screening of approximately 2.5 x 10(4) yeast colonies. All clones expressed transcripts of the same galactanase gene. The cDNA was re-cloned in an Aspergillus expression vector and transformed into Aspergillus oryzae. The recombinant enzyme had a molecular weight of 44,000 Da, an isoelectric point of pH 2.85, a pH optimum of pH 4.0-4.5, and a temperature optimum of 45-65 degrees C, which is similar to values obtained for a beta-1,4-galactanase purified from A. aculeatus. The enzyme degraded unsubstituted galactan to galactose and galactobiose. The deduced primary sequence of the enzyme showed no apparent homology to any known enzyme, in accordance with this being the first reported beta-1,4-galactanase cDNA. However, the deduced amino-acid sequence of a Bacillus circulans DNA sequence containing an open reading frame (ORF) with no known function, showed 36% identity and 60% similarity to the galactanase amino-acid sequence.
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7788715
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Molecular genetic properties of the yeast Torulaspora pretoriensis: characterization of chromosomal DNA and genetic transformation by Saccharomyces cerevisiae-based plasmids.
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Chromosomal DNA banding patterns were obtained for three strains of Torulaspora pretoriensis by contour-clamped homogeneous-electric-field gel electrophoresis. Chromosomes were resolved into six or seven bands in the range of 800 to 2000 kb, and a polymorphism of these lengths was observed. By Southern-blot analysis, the three strains were shown to lack the DNA sequences homologous to the URA3, LEU2, TRP1, and HO genes of Saccharomyces cerevisiae. A uracil auxotrophic mutant derived from T. pretoriensis was transformed with three plasmids (YEp24, YRpHI, and YCp50) carrying the URA3 gene of S. cerevisiae by the lithium acetate method.
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7788713
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Control of glucose influx into glycolysis and pleiotropic effects studied in different isogenic sets of Saccharomyces cerevisiae mutants in trehalose biosynthesis.
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The GGS1/TPS1 gene of the yeast Saccharomyces cerevisiae encodes the trehalose-6-phosphate synthase subunit of the trehalose synthase complex. Mutants defective in GGS1/TPS1 have been isolated repeatedly and they showed variable pleiotropic phenotypes, in particular with respect to trehalose content, ability to grow on fermentable sugars, glucose-induced signaling and sporulation capacity. We have introduced the fdp1, cif1, byp1 and glc6 alleles and the ggs1/tps1 deletion into three different wild-type strains, M5, SP1 and W303-1A. This set of strains will aid further studies on the molecular basis of the complex pleiotropic phenotypes of ggs1/tps1 mutants. The phenotypes conferred by specific alleles were clearly dependent on the genetic background and also differed for some of the alleles. Our results show that the lethality caused by single gene deletion in one genetic background can become undetectable in another background. The sporulation defect of ggs1/tps1 diploids was neither due to a deficiency in G1 arrest, nor to the inability to accumulate trehalose. Ggs1/tps1 delta mutants were very sensitive to glucose and fructose, even in the presence of a 100-fold higher galactose concentration. Fifty-percent inhibition occurred at concentrations similar to the Km values of glucose and fructose transport. The inhibitory effect of glucose in the presence of a large excess of galactose argues against an overactive glycolytic flux as the cause of the growth defect. Deletion of genes of the glucose carrier family shifted the 50% growth inhibition to higher sugar concentrations. This finding allows for a novel approach to estimate the relevance of the many putative glucose carrier genes in S. cerevisiae. We also show that the GGS1/TPS1 gene product is not only required for the transition from respirative to fermentative metabolism but continuously during logarithmic growth on glucose, in spite of the absence of trehalose under such conditions.
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7788714
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Molecular cloning of Rab-related genes in the yeast Yarrowia lipolytica. Analysis of RYL1, an essential gene encoding a SEC4 homologue.
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Small GTP-binding proteins of the Rab family are involved in the vesicular traffic inside eukaryotic cells. A gene library from the yeast Yarrowia lipolytica was screened with an oligonucleotide deduced from a highly conserved sequence in the Rab family. Four different genes were isolated. One of them, RYL1, was shown to be essential for cell viability. RYL1p displayed a high similarity with and tight phylogenetic relationships to SEC4p. When placed under the control of the GAL10 promoter, RYL1 was able to specifically relieve the thermosensitivity of a sec4-8 mutant of Saccharomyces cerevisiae. Therefore, it is proposed that RYL1 is a functional homologue of the S. cerevisiae SEC4 gene and is involved in the fusion of secretory vesicles with the plasma membrane in the general protein secretion pathway.
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7788712
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Interactions among mutations affecting spontaneous mutation, mitotic recombination, and DNA repair in yeast.
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The mutant alleles mms9-1, mms13-1, or mms21-1 of Saccharomyces cerevisiae confer pleiotropic effects, including sensitivity to the alkylating agent methyl methanesulfonate, elevations in spontaneous mutation and mitotic recombination, defects in meiosis, and cross-sensitivity to radiation. We constructed double-mutant strains containing an mms mutation and a defect in either excision repair, mutagenic repair, or recombinational repair and measured the levels of spontaneous mutation and mitotic recombination. Double mutants lacking excision repair show elevations in spontaneous mutation but with predominantly unchanged levels of mitotic recombination. RAD52 function was required for the expression of the hyper-recombination phenotype of the mms9-1, mms13-1, and mms21-1 alleles; double mutants displayed the very low recombination levels characteristic of rad52 mutants. Phenotypes of double mutants containing one of the mms alleles and either of the hyper-recombination/mutator rad6-1 or rad3-102 alleles suggest that the mutagenic lesions in mms strains may not be identical to the recombinogenic lesions.
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7788708
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[The carotid body--mechanisms of hypoxia sensing].
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The carotid body is a peripheral chemoreceptor monitoring arterial blood gas tension and pH and contributing to the regulation of breathing. The molecular mechanism of oxygen sensing is unknown. However, it is hypothesised that lowering of arterial oxygen tension detected by O2 sensitive K+ channels, evokes a selective inhibition of K+ current of glomus cells, with an increase of cellular excitability. Hydrogen peroxide production within the glomus cells may serve as a messenger which regulates potasium channels or gene expression.
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7788707
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[Do the kidneys play an important role in the pathogenesis of "essential" hypertension?].
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The Prague Hypertensive Rat (PHR) is a model of genetic hypertension derived from the Wistar strain, in which a normotensive parallel, the Prague Normotensive Rat (PNR), was also bred from the same parent pair. Thus, it is possible to transfer organs between both parallels without signs of rejection and without the use of immunosuppressive drugs. Unilateral nephrectomy and transplantation of one kidney within the PHR and PNR groups did not affect the systolic blood pressure (SBP). Transplantation of one kidney from PNR to a bilateral nephrectomized (BNX) PHR normalized the high SBP; and transplantation of one kidney from PHR to BNX PNR led to an elevation of SBP: hypertension "travels" with the kidney. When the development of high SBP in PHR was prevented for 2 months after weaning by antihypertensive drugs, transplantation of one kidney from these rats to BNX PNR always induced a sustained hypertension in the recipient. If a PHR was left with one original kidney in situ after transplantation of a "normotensive" kidney, the high blood pressure persisted until the original "hypertensive" kidney was removed. These results support the view that the kidney of PHR produces a "hypertensinogenic" substance, the secretion of which is genetically determined and is not influenced by the magnitude of the SBP.
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7788704
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Systemic anaphylactoid reactions to iodinated contrast media during cardiac catheterization procedures: guidelines for prevention, diagnosis, and treatment. Laboratory Performance Standards Committee of the Society for Cardiac Angiography and Interventions.
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This report represents the first guidelines for prevention, diagnosis, and treatment of anaphylactoid reactions to contrast media occurring specifically during cardiac catheterization. The incidence of contrast media complications in the catheterization laboratory is 0.23% with 1 death per 55,000. Anaphylactoid reactions are nonimmune mediated, but histamine release and other mediators produce a clinical presentation indistinguishable from anaphylaxis. In patients with known previous reactions, pretreatment with steroids and diphenhydramine and the use of nonionic contrast media have significantly reduced the potential of recurrent reaction. Minor reactions such as limited urticaria may be watched for progression or treatment with diphenhydramine, whereas more serious reactions such as angioedema or laryngeal edema require airway stability and ephinephrine administration. Shock should be vigorously treated simultaneously with intravenous epinephrine and large volumes of normal saline. If the patient can be stabilized, the study should be completed as histamine, leukotrienes, and other vasoactive products should be relatively depleted.
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7788706
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[Adrenergic receptors--nomenclature and classification of the types and subtypes].
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The purpose of this review is to present current knowledge regarding adrenergic receptors and their subtypes. These receptors belong to the superfamily of structures with seven transmembrane domains. They are coupled with G-regulatory proteins. Similarly to other membrane receptors, their division is based on three criteria: structural, transductional, and operational. At present, adrenergic receptors are divided into three main groups, depicted as alpha 1, alpha 2 a beta receptors. Receptors alpha 1 and alpha 2 are further divided into additional 4 subtypes, which are marked with upper case subscripts A-D. Receptors beta are subdivided into three types, marked with subscripts 1-3. Classification of adrenergic receptors can be considered as a prototype for classification of other membrane receptors. The significance of all known receptors subtypes is not yet known. Multiple subtypes of adrenergic and also other receptor types exist simultaneously not only in one tissue but also frequently in a single cell where they can exert both synergistic as well as antagonistic effects. The discovery of functions and interactions of individual receptor subtypes represents a big challenge for future studies. Introduction of new selective agonists and antagonists not only helps to classify various receptor subtypes but it also has a big therapeutic potential.
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7788705
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[Nomenclature and classification of membrane receptors and their subtypes].
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Present rapid growth of information about receptors for endogenous ligands and drugs requires changes in definitions, nomenclature and classifications of receptors and their subtypes. Receptors are defined as such membrane structures for which we have sufficiently reliable characterization of their structure, transducing mechanisms (mediation of intracellular effects), and selectively acting drugs (operational criterion). This characterization is based on the integrated approach to classification that relies on all three essential criteria. The current classification of membrane receptors is organized by International Union of Pharmacology Committee on Receptor Nomenclature and Drug Classification (NC-IUPHAR). Their conclusions about receptor classifications are regularly published in pharmacological journals and in special publications. List of presently known membrane receptors and their subtypes is provided in this review.
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7788699
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Effect of data compression on quantitative coronary measurements.
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Digital coronary and left ventricular angiography demand high transfer rates and very large data storage if all the clinical data are to be achieved. If appropriate compression schemes were available without compromising the quality and resolution of the image data, such demands could be lessened. In this study we compared the influence of different compression factors of the Adaptive Real Time Image Compression (ARTIC) scheme used on the Philips DCI-SX systems on coronary measurements assessed with the Automated Coronary Analysis (ACA) package. Loss-free acquired images of size 512(2) x 8 bits, which had been stored digitally on tape, were reloaded into the DCI with compression factors of 2, 3, and 4; only the factor 2 is loss free. To evaluate the effect of the different data compressions on the accuracy of the measurements, the diameters of a vessel phantom (tube sizes ranging from 0.687 to 5.062 mm) were determined. To evaluate the reproducibility of the results, the intraobserver variability was determined for the different compression factors from 40 coronary obstructions. The differences in the reference diameter measurements of the vessel phantom were -0.03 +/- 0.06 mm, 0.01 +/- 0.07 mm, and 0.04 +/- 0.08 mm for the compression factors 2 (loss free), 3, and 4, respectively. The results were not statistically significantly different. The intraobserver variabilities in the obstruction diameter measurements of the coronary obstructions were -0.04 +/- 0.13 mm, 0.00 +/- 0.14 mm, and 0.02 +/- 0.13 mm for the compression factors 2, 3 and 4, respectively. The intraobserver variabilities in the reference diameter measurements were -0.02 +/- 0.12 mm, 0.01 +/- 0.09 mm, and 0.03 +/- 0.09 mm for the compression factors 2, 3, and 4, respectively. The intraobserver variabilities of the percent diameter stenosis were 0.96 +/- 4.19%, -0.01 +/- 4.88% and -0.04 +/- 4.68% for the compression factors 2, 3, and 4, respectively. None of these differences were statistically significant. Both from a qualitative and quantitative point of view, data compression factors 3 and 4 are acceptable in digital coronary arteriography.
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7788698
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Collateral flow velocity alterations in the supply and receiving coronary arteries during angioplasty for total coronary occlusion.
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The unique observations of contralateral and ipsilateral coronary artery collateral supply before and after angioplasty suggest highly responsive conduits to hemodynamic conditions. The study of collateral supply system is not only significant for our current understanding of the dynamic behavior of the collateral circulation, but may also have important clinical implications for the treatment of patients with a chronic coronary occlusion.
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7788697
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Successful transcatheter management of Palmaz Stent embolization after superior vena cava stenting.
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A 34-year-old patient with benign superior vena cava syndrome (SVCS) was treated with thrombolytic therapy, balloon angioplasty, and placement of two peripheral Palmaz stents. Embolization of one stent to the right atrium occurred 10 min after successful implantation. This serious complication was successfully managed by percutaneous transcatheter technique with retrieval from the right atrium and subsequent deployment into the right external iliac vein of the lost stent. Complete resolution of SVCS symptoms occurred within 24 hr and moderate superior vena cava restenosis was successfully dilated 8 months later. At 12-month follow-up the patient continues to be asymptomatic.
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7788696
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Retrieval of occluding unexpanded Palmaz-Schatz stent from a saphenous aorto-coronary vein graft.
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The Palmaz-Schatz coronary stent is used frequently to reduce the rate of restenosis of balloon angioplasty in saphenous vein grafts. In many European centers, the stent, manually crimped on a balloon, is advanced across the stenosis without a protective sheath. This report describes a patient in whom an attempt to deploy a stent in the orifice of a saphenous vein graft was complicated by dislodgement of the unexpanded stent from the balloon. The unexpanded stent caused immediate occlusion of the vein graft and severe ischemic symptoms. The stent was retrieved by inflation of another balloon in the graft, distal to the stent, pulling the balloon toward the guiding catheter, and then withdrawing the whole system.
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7788695
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Sequential implantation of dissimilar tandem stents for long dissections complicating percutaneous transluminal coronary angioplasty.
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Acute closure remains a significant complication of percutaneous angioplasty, and coronary artery stenting serves as a useful bail-out device. We describe two cases of sequential implantation of dissimilar tandem stents, a Gianturco-Roubin (4 x 20mm) stent and a Palmaz-Schatz (4 x 15mm) stent, for long dissection complicating percutaneous transluminal coronary angioplasty.
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7788694
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Treatment of acute stent thrombosis with local urokinase therapy using catheter-based, drug delivery systems: a case report.
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Abrupt thrombotic stent closure remains a difficult problem to treat in the cardiac catheterization laboratory. A 63-yr-old white female initially underwent successful placement of a Palmaz-Schatz biliary stent in the proximal RCA following failed coronary angioplasty. One week later, the patient represented with an acute inferior infarction and thrombotic occlusion of the stent site in spite of adequate anticoagulation. A new, local drug infusion catheter (the Dispatch catheter) was placed at the angioplasty site and 150,000 units of urokinase were locally infused, with immediate restoration of normal distal flow and a subsequent marked decrease in angiographic thrombus. A small, residual thrombotic filling defect was further treated with a urokinase-coated hydrogel balloon (Hydro Plus). Following local urokinase delivery with the Dispatch catheter and hydrogel balloon, there was complete resolution of angiographic thrombus with TIMI 3 flow and no evidence of distal embolization or no-reflow. Local urokinase delivery directly to the site of thrombus with catheter-based drug delivery systems may be a useful technique for rapidly lysing intracoronary clot and re-establishing coronary flow in the setting of acute stent thrombosis.
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7788690
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Emergency endoluminal stenting for abrupt vessel closure following coronary angioplasty: a randomized comparison of the Wiktor and Palmaz-Schatz stents.
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In order to compare the efficacy of two different stent types in case of bailout stenting, 65 patients, with abrupt or threatened vessel closure following coronary angioplasty, were randomly assigned to either Wiktor (Medtronic Inc., Minneapolis, MN, 33 patients) or Palmaz-Schatz (Johnson & Johnson Interventional, Warren, NJ, 32 patients) stent implantation. Stenting was technically feasible in all except one patient and immediately successful in reverting ischemia and vessel closure in 60 patients (92%). At hospital discharge, complication rates were comparable: early vessel closure, 18% (Wiktor) versus 13% (Palmaz-Schatz) (P = 0.53); any clinical event (such as death, myocardial infarction, and surgical revascularization): 18% (Wiktor) versus 22% (Palmaz-Schatz) (P = 0.71). At 6 months follow-up, these complication rates remained equal: restenosis, 38% (Wiktor) versus 27% (Palmaz-Schatz) (P = 0.42); any clinical and angiographic (vessel closure and restenosis) event: 45% (Wiktor) and 41% (Palmaz-Schatz) (P = 0.69). Baseline, direct postprocedural, and follow-up quantitative coronary analysis data were similar, with, however, an exception for the postprocedural residual stenosis [28% (24-32%) (Wiktor) and 21% (18-23%) (Palmaz-Schatz] (means and 95% confidence intervals). In conclusion, despite a discrete postprocedural angiographic benefit observed with the Palmaz-Schatz stent, the long-term clinical and angiographic outcome is similar in both treatment groups. The choice whether to implant a Wiktor or Palmaz-Schatz stent may probably be left to the discretion of the operator and his experience with one particular device.
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7788692
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Coronary stenting without anticoagulation.
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Stents are useful bail-out devices in coronary angioplasty. They are also used electively for situations associated with poor angioplasty results (e.g., restenotic lesions, venous grafts) and may reduce restenosis rates. However, the significant incidence of stent thrombosis necessitated aggressive anticoagulation with associated hemorrhagic complications. This remains a major limitation of stenting. We present our experience of stenting with half (disarticulated) Palmaz-Schatz coronary stents in eight consecutive patients, managed with aspirin alone. No patient experienced acute or subacute stent thrombosis.
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7788691
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Percutaneous transradial coronary Palmaz-Schatz stent implantation, guided by intravascular ultrasound.
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Intravascular ultrasound (IVUS) allows accurate assessment of stent deployment, its use being confined to the use of 8 French (F) guiding catheters. We evaluated the feasibility of combining transradial artery Palmaz-Schatz stent implantation through 6F guiding catheters with IVUS for assessment of stent diameter after delivery at moderate inflation pressures (10-12 atmospheres [atm]) with compliant balloons and after high pressure dilatations with balloons of intermediate compliance. In 8 consecutive patients, 12 stents were delivered with Scimed Express balloon catheters at 10-12 atm followed by IVUS (EndoSonics CathScanner; Visions FX 3.5F 20 MHz transducer). An ultrasound study was repeated after high pressure dilatations (16-20 atm) with Schneider Magical Speedy balloon catheters. The balloon diameters were derived from manufacturer provided specifications. In all patients the transducer could easily be advanced through the guiding catheters. Reference diameter of the stented segment was 3.7 +/- 0.5 mm (2.7-4.5) and the diameter of Scimed Express balloons during inflation was 4.0 +/- 0.3 mm (3.6-4.7). Stent diameter was 3.0 +/- 0.1 mm (2.8-3.2) (P < 0.001 compared to the reference and the balloon diameter). The diameter of the Schneider Magical Speedy balloons at secondary dilatations with 16 +/- 3 atm (14-20) was 4.1 +/- 0.4 mm (3.3-4.5) (P = 0.50 compared to the initial balloon diameter). Final stent diameter was 3.3 +/- 0.4 mm (2.9-4.1) (P = 0.02 compared to the initial stent diameter). All stents were symmetrically deployed and well apposed. No damage to vessel or stents was detected after passage of the transducer.(ABSTRACT TRUNCATED AT 250 WORDS)
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7788689
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Stenting with the half (disarticulated) Palmaz-Schatz stent.
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A total of 110 half (disarticulated) Palmaz-Schatz coronary stents were implanted in 102 patients. Procedural success rate was 98%. Elective stenting was performed in five patients. The others received half stents for bail-out situations, including short dissections, relapsing stenoses, dissections not adequately covered by a full stent, ostial stenoses, and thrombus containing lesions. Seventeen patients received no anticoagulation except aspirin. Complications included one procedural death, three acute occlusions (resulting in one Q and two non-Q wave myocardial infarctions), and one non-Q wave infarction related to side branch closure. Stenting with the half Plamaz-Schatz coronary stent is an effective technique. It allows stenting in situations where a full stent may not be ideally suited. Use of only half a stent reduces thrombogenicity and halves costs.
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7788688
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Transluminal extraction catheter for the treatment of diseased saphenous vein grafts: a multicenter experience.
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To evaluate the efficacy, safety, and long-term results of atherectomy using the Transluminal Extraction catheter (TEC), patients with diseased saphenous vein grafts were enrolled in a prospective nonrandomized trial. Patients were followed to hospital discharge for acute complications and underwent routine 6-mo reevaluation with repeat cardiac catheterization to assess restenosis. Atherectomy was performed on 650 graft lesions in 538 consecutive patients (male 81%; mean age 66 yr; range 37-81). Mean graft age was 8.3 yr; (range 0.3-20) with 85% of grafts > 3 yr of age. Complex lesion morphology included thrombus (28%), ulceration (13%), and eccentricity (50%). Lesion success was achieved in 606 lesions (93%) with clinical success in 479 patients (89%). Lesion success was achieved in 90% of thrombus containing lesions, 97% of ulcerated lesions, and 97% of grafts > 3 yr. Complications included nonfatal myocardial infarction in 4 (0.7%) of patients, emergency bypass surgery in 2 (0.41%), and in-hospital death in 17 patients (3.2%). Angiographic follow-up at 6 mo was obtained from 268 lesions in 227 patients. The overall lesion angiographic restenosis rate was 60%. TEC atherectomy can be performed in patients with diseased saphenous vein grafts with high primary success and low complication rates. It is suitable for use in aged grafts, particularly in the presence of thrombus and ulcerations, and may be superior to balloon angioplasty alone in this group of patients.
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7788687
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Prolonged urokinase infusion for chronic total native coronary occlusions: clinical, angiographic, and treatment observations.
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Prolonged intravascular infusion of urokinase has proven beneficial in reestablishing patency of chronically occluded peripheral arteries and saphenous vein grafts. This study was performed to assess the efficacy and safety of prolonged urokinase infusion as a prelude to angioplasty in chronically occluded native coronary arteries, that had failed standard angioplasty techniques. Twenty-five patients with objective evidence for ischemia in the distribution of a chronic coronary occlusion were referred for percutaneous intervention. Patients were assessed for any potential exclusions from lytic therapy. Urokinase infusion through both a SOS wire and a stable guiding catheter was continued at 100,000-240,000 units/hr for 8-25 hr; patients then underwent attempted balloon angioplasty. Mean duration of urokinase infusion was 20.6 +/- 7.7 hr (total dose 163,000 +/- 52,447 units/hr). Fibrinogen levels dropped slightly with this (300 +/- 129 to 203 +/- 81 mg/dl, P = 0.02). Angiography posturokinase showed improvement in 7 (28%) with regard to coronary flow (> or = 1 TIMI-grade). Angioplasty was successful in 13 (52%), with final angiographic result revealing thrombus in 5 (20%), or dissection 8 (32%). The infusions were well-tolerated with a low incidence of chest pain, 2 (8%) or ischemic ECG response, 2 (8%); myocardial infarction, 2 (8%); or significant bleeding 2 (8%). All patients survived the procedure, with a length-of-hospital stay = 5.1 +/- 4 days. Use of prolonged preangioplasty intracoronary urokinase infusion can be done safely with success in roughly one-half of patients with chronic total native coronary occlusions who have failed prior attempts at percutaneous intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
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7788685
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Antimicrobial susceptibilities of Shigella dysenteriae type 1 isolated in Zimbabwe--implications for the management of dysentery.
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Shigella dysenteriae type 1 was cultured from 56/170 (33 pc) rectal swab specimens collected from patients presenting to hospitals in Harare, Zimbabwe with dysentery. All of the isolates were resistant in vitro to trimethoprim-sulfamethoxazole, with MICs > 32 mg/l, and all except one were resistant to ampicillin, most with an MIC > 256 mg/l. One isolate was resistant to nalidixic acid (MIC > 256 mg/l), but all of the others were sensitive, most with an MIC of 2 mg/l or less. Using antibiotic disks, 96 pc isolates were resistant to chloromphenicol and 94 pc to tetracycline. All isolates were sensitive in vitro to gentamicin. On the basis of these findings, we suggest that commonly available antibiotics including ampicillin, cotrimoxazole, chloramphenicol or tetracycline should not be used for the treatment of dysentery. The most appropriate antimicrobial agent at the present time would be nalidixic acid. Resistance to this is, however, likely to emerge and data on susceptibilities to fluoroquinolones as well as to cephalosporins should be obtained so that further recommendations can be given timeously.
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7788683
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Effect of Plasmodium falciparum malaria on plasma fibrinopeptide-A (FpA) concentration.
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Plasma Fibrinopeptide-A (FpA) concentrations were determined using Enzyme-linked Immunosorbent Assay (ELISA) in patients with acute Plasmodium falciparum malaria infection and in 30 healthy controls. The mean FpA levels of the malaria patients were significantly raised (p < 0.001). The patients' FpA level correlated positively with malaria parasitaemia, but negatively with plasma fibrinogen concentration. A week after commencement of chloroquine therapy and subsequent disappearance of malaria parasites from the thick blood films, the patients' FpA levels decreased significantly from pre-treatment values. It is suggested that the elevated FpA and reduced plasma fibrinogen levels in the patients probably indicate a more widespread existence of overt coagulation defect in acute malaria infection.
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7788682
|
Effects of ACE inhibition on left ventricular dimensions and haemodynamics in systemic hypertension: a radionuclide and echocardiographic study.
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The aim of this study was to assess the effects of Angiotensin Converting Enzyme (ACE) inhibition on cardiac systolic and diastolic parameters and left ventricular muscle mass in hypertensive patients. For this purpose 30 patients (22 female and eight male) with mild to moderate essential hypertension, aged 47 +/- 2 years, were treated with enalapril maleate (MK 421, an ACE inhibitor) for six weeks. They underwent M-mode and Doppler echocardiography and radionuclide ventriculography at the beginning and after six weeks of enalapril treatment. In this study all patients treated with the ACE inhibitor enalapril responded with a significant decrease in mean arterial pressure (p < 0.001). A significant reduction in left ventricle and mass index were shown after six weeks of treatment with enalapril (p < 0.01). Total peripheral resistance and end-systolic stress decreased in the same time course (p < 0.001). Ejection fraction increased in both examinations after six weeks of therapy with enalapril, but this increase was not statistically significant. In radionuclide examinations, time to peak filling rate decreased significantly after six weeks of enalapril therapy (p < 0.02). Despite these improvements in cardiac systolic and diastolic parameters, cardiac output and stroke volume decreased slightly after enalapril treatment. We concluded that enalapril improves diastolic and systolic parameters in LV function but causes slight decreases in cardiac output and stroke volume in addition to lowering blood pressure.
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7788681
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Who are the Zimbabwean loop users? The social and demographic characteristics of Zimbabwean IUCD users.
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As part of a study into the reasons for the low utilization of the intra-uterine contraceptive device (IUCD) among Zimbabwean women, a records' review of IUCD users over the period 1985 to 1989 was carried out. A 10 pc sample of the records of women inserted over this period was taken. This paper reports on the social demographic and selected screening characteristics of these women. A total of 1,179 records were reviewed. The IUCD users had a higher socio-economic status than the Zimbabwean population as a whole. Nearly 20 pc of the IUCD users were professional, technical and related workers, (mostly nurses and teachers), compared to 4.3 pc among the general population. Clients had apparently better reproductive histories than the population as a whole, probably reflecting their socio-economic status and possibly the screening process. The women were in their mid to late twenties in age at the time of insertion, and had been married an average of nine years. A quarter of the clients did not want any more children. They were using the IUCD to suspend their conception indefinitely after completion of their families. About 74 pc of the women had learnt about the family planning clinic from the local clinic/nurses or the community based distributor, indicating the importance of these sources of information. Eighty pc of the women were previous acceptors of modern contraceptives, but only 6 pc had apparently used the IUCD before.(ABSTRACT TRUNCATED AT 250 WORDS)
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7788680
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A community based investigation of causes of maternal mortality in rural and urban Zimbabwe. Maternal Mortality Study Group.
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Most data on maternal mortality in Zimbabwe has been urban hospital based. Using a network of informants and sensitized health workers an attempt was made to identify and investigate all maternal deaths in rural Masvingo and urban Harare over a two year period. The present report discusses place of death and the medical causes in both populations. Results gave maternal mortality rates of 168 and 85 per 100,000 live births for Masvingo and Harare respectively. These rates are significantly higher than those from conventional reporting systems especially in the rural area where 27 pc of deaths occurred at home or in transit. The leading medical causes of death were haemorrhage in Masvingo (25 pc of deaths) and eclampsia in Harare (26 pc), with puerperal and post abortal sepsis as the next most common causes in both cases. Malaria featured as the major indirect cause in Masvingo (7.6 pc). There were four suicides committed following unwanted pregnancy. The rural/urban variation in causation of death is discussed and the study results compared with other community based studies internationally. This community based study revealed higher maternal mortality rates (MMR) than conventional statistics, especially in the rural area where deaths occurred at home or in transit. In the rural area the MMR was higher and the leading cause of death was haemorrhage, compared to eclampsia in the urban area. Strategies to reduce maternal deaths should include factors both within and outside health service structures.
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7788679
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A case of psychotic mood disorder in an AIDS patient.
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The following case is reported not because it is uncommon, but rather because cases like it will become more common as the AIDS endemic in sub-Saharan Africa progresses. This is a case of a young woman previously undiagnosed as being HIV positive who was admitted to a psychiatric unit. She clinically presented with a manic episode. The case is remarkable in that it demonstrates the complicated differential diagnosis that needs to be considered in evaluating immune-compromised patients who present primarily with disturbances of mood, cognition, or behaviour.
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7788678
|
Appendicitis in south eastern Nigerian children.
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One hundred and sixty nine cases of acute appendicitis were seen among 760 children aged to zero to 15 years treated for a variety of acute abdominal emergencies in the University of Calabar Teaching Hospital (UCTH), Calabar, during the period January 1982 to 1991. This condition ranks second among cases of acute abdominal emergencies in this group of patients. Those aged 13 to 15 years formed the majority (59 pc) of the children undergoing appendicectomy. As is the experience of other authors, appendicitis is rare under the age of three years. A female preponderance is observed in our study with a male: female ratio of 1:1,6 in contrast to reports elsewhere. The reason for this reversal is not clear. Parasitic infestation due to Ascaris lumbricoides involved 3 pc of our cases. This may be of significance in the aetiology of this disease. Despite the long delay in surgical intervention, no death was reported. Complications such as gangrene and perforation with peritonitis were recorded in only 8 pc of the patients. This favourable outcome despite a delay in initiating treatment may be related to self-medication with antimicrobials before reporting to the hospital.
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7788677
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Prevalence of Campylobacter enteritis in children from Yaounde (Cameroon).
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A cross sectional study on the prevalence of Campylobacter jejuni/coli and its possible aetiologic role in childhood diarrhoea in Yaounde was undertaken in 272 children presenting with diarrhoea and 157 age matched controls from April 1989 to October 1990. Stool cultures were performed according to standard techniques for Campylobacter jejuni/coli shigella and salmonella species. Rotavirus was detected using a latex agglutination test. Campylobacter jejuni/coli was isolated from 21 (7,7 pc) of 272 patients with diarrhoea and five of 157 (3,2 pc) controls (p > 0.05), all aged zero to four years old. Shigella and salmonella species were cultured from 2,2 pc and 1,1 pc of 272 patients respectively while rotavirus antigen was detected in 19,6 pc of 204 patients. Twenty eight pc of children with Campylobacter enteritis were exposed to chickens while 23,8 regularly drank water from streams which probably were contaminated. Our results indicate a high prevalence of campylobacter enteritis in children living in Yaounde and also suggest that a high rate of carriage of Campylobacter jejuni/coli could exist in children zero to four years without diarrhoeal illness. to four years without diarrhoeal illness.
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7788676
|
Splenic and hepatic trauma: a three year review.
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We present a three year study of 22 consecutive patients treated for splenic and liver injuries at Mpilo Central Hospital between 1988 and 1990. A total of eight patients died giving an overall mortality rate of 36 pc. There was no mortality recorded in nine patients (41 pc) treated for splenic injuries. However, of the nine patients (41 pc) treated for liver injuries four patients died giving a mortality rate of 44 pc in this group. The highest mortality rate was recorded in the group of patients with both splenic and liver injuries because these injuries were invariably associated with other severe multiple injuries. We admitted four patients (18 pc) in this group and they all died.
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7788675
|
In vitro activity of several antimicrobial agents against Neisseria gonorrhoeae and comparison of cost of treatment.
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During a cross sectional study on the prevalence and incidence of gonorrhoea, Neisseria gonorrhoeae was isolated from 185 people aged between 16 and 60 years. In vitro activity of six antimicrobial antibacterial agents, penicillin, erythromycin, tetracycline, cotrimoxazole, ceftriaxone and norfloxacin on the isolated N. gonorrhoeae were carried out. The results obtained showed that, of all 111 isolates, 48 (43.2 pc) were penicillinase producing N. gonorrhoeae (PPNG) and 63 (56.8 pc) were non PPNGs. Over 90 pc of both PPNG and non PPNG isolates were sensitive to tetracyline and erythromycin. Seventy five pc of the PPNG and 45 pc non-PPNG were not sensitive to two units of penicillin. Both PPNG and non-PPNG were less sensitive to cotrimoxazole 25 micrograms. Norfloxacin and ceftriaxone were over 70 pc effective but were extremely expensive for most people who got infected.
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7788674
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Neonatal haematology in Zimbabwe. II: The red cell and white cell parameters.
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Red cell and white cell parameters were determined in 600 (310 male and 290 female) normal Black Zimbabwean neonates with a mean +/- sd birth weight of 3.0 +/- 0.4 (range 2.04 to 4.50, median 3.0) kg using a Coulter Counter Model S Plus. Cord anaemia (cord Hb < 13.5 gdl-1) was detected in 60 (10 pc) of the neonates. Although the male babies were significantly heavier than the females (p = 0.004), there were no significant differences (p > 0.05) in the red cell and white cell indices between the two sexes. When the haematological parameters of the 540 (90 pc) non-anaemic (cord Hb > or = 13.5 gdl-1) neonates were analysed, the mean +/- sd values which may serve as local reference standards were: Hb 15.2 +/- 1.8 (range 13.5 to 19.4) gdl-1, Hct 47.3 4.9 (range 38.6 to 60.3) pc, MCV 107.8 +/- 9.4 (range 88.8 to 134.3) fl, MCH 31.9 +/- 3.4 (range 25.2 to 45.2) pg, MCHC 32.9 +/- 1.3 (range 30.0 to 38.3) gdl-1, nucleated red blood cells 6.1 +/- 5.9 (range 0 to 55) per 100 white blood cells, reticulocyte count 5.0 +/- 1.9 (range 0 to 24.0) pc, total leucocyte count 13.8 +/- 4.4 (range 4.6 to 132.8) x 10(9)l-1; differential count: neutrophils 7.30 +/- 2.90 (range 1.72 to 18.02) x 10(9) l-1, lymphocytes 5.67 +/- 2.47 (range 0.98 to 16.14) x 10(9) l-1, monocytes 0.81 +/- 0.83 (range 0 to 5.58) x 10(9) l-1, 1 and eosinophils 0.08 +/- 0.13 (range 0 to 0.72) x 10(9)l-1.(ABSTRACT TRUNCATED AT 250 WORDS)
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7788673
|
Legal aspects of medical research and the way forward.
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The main thrust of this article is to examine critically the laws and ethics governing medical research in this country--Zimbabwe. The article is divided into two parts. The first part starts with an introduction which highlights the need for medical research and the hazards related thereto. This is followed by stating the general legal position aimed at controlling medical research, the emphasis being on law, the international codes of medical ethics intended to fill the wide gaps not covered by our legislations and individual ethical considerations. The other topics covered in the first part include confidentiality in research and compensation for those who suffer injuries while undergoing a clinical trial. The second part covers the following topics; informed consent, stressing on the need for informed consent from both adults and children when carrying out medical research; embryo research and researchers carried out by n'angas and finally the conclusion suggesting the need to re-examine laws relating to medical research in this country which seem to be wholly inadequate. In brief the article is intended to stimulate more public debate on the law relating to medical research. For example a question is often asked: Does the law adequately protect those who carry out medical research and conversely those upon whom medical research (or clinical trials) is done?
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7788670
|
Three consecutive ipsilateral tubal pregnancies in a nulliparous African woman: the role of conservative treatment.
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A very rare case of three consecutive ipsilateral tubal pregnancies, in a 31 year old nulliparous Malawian woman is presented. The three pregnancies occurred over a four year period between 1989 and 1993, and were treated at three different hospitals in Malawi and Britain. The first two were treated conservatively by "milking" the ectopic out in Malawi and Britain respectively while the third was treated by partial salpingectomy in Malawi. All three were confirmed clinically, ultrasonographically, at surgery and histopathologically. The rarity of such a condition, the role and value of conservative treatment of tubal pregnancy in Africa, especially in the light of the probable aetiological and/or predisposing factors are discussed.
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7788669
|
Haemophilia in northern Nigeria.
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Thirteen patients from 11 families were diagnosed as cases of haemophilia A or B during 1977 to 1984. The majority presented with post circumcisional bleeding. Cryoprecipitate and packed red cells were used in the management. Haemophilia and other inherited bleeding disorders are not as rare as otherwise assumed. This is the first report from Northern Nigeria.
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7788668
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Acute bacterial meningitis in Enugu, Nigeria. 1 April 1989 to 31 March 1993.
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A total of 84 cases of meningitis confirmed by isolation of the organisms at the University of Nigeria Hospital (UNTH) Enugu, Nigeria between 1 April 1989 and 31 March 1993 are presented. The cases are analysed by diagnosis, seasonal distribution, age and sex distribution and age specific case fatality rate. The most common type of meningitis was pneumococcal meningitis 32 cases, followed by coliform meningitis 31 cases and meningococcal meningitis, six cases. Other bacterial causes of meningitis accounted for 15 cases. The majority of cases occurred in infants, followed by children, with all cases occurring sporadically. Mortality was high with Streptococcus pneumoniae having the highest case fatality rate of 28.13 pc followed by coliforms, 25.78 pc. Fifty pc of the patients had pre-medication before presentation at the hospital, and many of the patients could not receive appropriate therapy because they were unable to afford the cost of the drugs. This probably contributed to the high mortality.
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7788667
|
Non-traumatic spinal cord diseases in Ibadan, Nigeria: aetiology and prognostic factors.
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In this hospital based study, we analysed the clinical records of 104 patients having various spinal cord diseases seen between 1988 and 1993 with a view to delineating diagnostic and prognostic features. The patients comprised 80 males and 24 females with a mean age of 45 years. The mean duration of disease at presentation was 11 months and the average duration of stay in hospital was five months. Spondylotic myelopathy (31 subjects) predominated. It showed cervical predilection, infrequent sphincteric dysfunction and low ESR. Tuberculous disease of the spine (26 subjects) was next in frequency. The presentation of the TB cases was similar to those of neoplastic causes but the latter had a worse prognosis. There was a predilection for the dorsal spine and a high ESR. Myelitis occurred in the younger age group, showed dorsal spine predilection and relatively low ESR. The prognostic factors include duration of disease at entry, duration of hospital stay, presence of complication, motor power above grade three and absence of flacidity. The preventable causes of death include: deep vein thrombosis with subsequent pulmonary embolism and septicaemia.
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7788666
|
Plasma levels of retinol, ascorbic acid and alpha-tocopherol in sickle cell anaemia.
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The plasma concentrations of the antioxidant vitamins A (retinol), C (ascorbic acid) and E (alpha-tocopherol) were determined in sickle cell anaemia (SCA). It was found that the concentrations of ascorbic acid and alpha-tocopherol were significantly depressed while that of retinol was only slightly reduced. The depletion in the levels of these antioxidant vitamins may account for some of the observed manifestations of SCA such as increased susceptibility to infection and haemolysis.
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7788665
|
Hydatidiform mole: a study of 40 patients admitted at Harare Central Hospital, Zimbabwe.
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Hydatidiform mole contributes to a significant numbers of hospital admissions at Harare Hospital. The characteristics, diagnosis, management and follow up of the women with molor pregnancy admitted to Harare Hospital are presented. The follow up of these women was grossly inadequate.
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7788664
|
Organophosphate exposure in pesticide formulation and packaging factories in Harare, Zimbabwe.
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A cross sectional study was conducted in September 1989 in order to estimate the prevalence of organophosphate exposure and to identify factors associated with increased organophosphate exposure in pesticide producing factories in Harare, Zimbabwe. Sixty five workers entered the study with 45 of them providing blood specimens. The mean cholinesterase level was 75.3 pc (standard deviation 21.07 pc). Twenty (44.4 pc) workers had cholinesterase levels of less than 75 pc. The workers had adequate knowledge (75 pc+) of the importance of protective devices but had less knowledge of about 50 pc of health effects of pesticides. Smoking (t = 3.49; degrees of freedom (df) = 43; p < 0.01) and eating (t = 2.14; df = 43; p < 0.05) at work place were associated with increased exposure to organophosphate. The number of symptoms was not correlated with cholinesterase levels (Spearman's rank correlation coefficient--0.70; p = 0.12). We conclude that a significant number of workers were exposed to organophosphate. Increased personal hygiene such as washing hands before eating or smoking should reduce the amount of exposure.
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7788663
|
More recent trends in infant and child mortality in Zimbabwe and possible explanations.
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The paper uses published results from the 1992 census to describe more recent trends in infant and child mortality in Zimbabwe. It is shown that the period 1986 to 1988 provided the turning point in the gradual decline in infant and child mortality in the provinces. After this period, several provinces experienced a slow-down in mortality decline while some even experienced reversals. Using correlation analysis, it was suggested that the factors which affected infant mortality could be the same ones affecting child mortality. The paper then proceeds to formulate hypotheses on possible explanations for the slow down in mortality decline.
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7788662
|
[Pulse therapy in diffuse connective tissue diseases].
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Methods of i.v. pulsed treatment using methyl prednisolone, cyclophosphamide or polyvalent immunoglobulin made it possible to suppress rapidly and effectively the activity of prognostically serious (clinical and laboratory) manifestations in diffuse connective tissue diseases (systemic autoimmune diseases). The author presents a general justification of this therapeutic method with emphasis on the immunogenetics of pathological autoimmunity (autogenes, apoptosis), he describes methodical aspects, the asset and partial clinical indications in rheumatoid arthritis, systemic lupus erythematosus, polymyositis and dermatomyositis, and primary systemic vasculitis. The author mentions also prerequisites of further development of i.v. pulsed treatment in diffuse connective tissue diseases.
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7788661
|
[The human genome--chromosome 11].
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The eleventh human chromosome is one of the most intensely studied and as regards the number of known genes it holds the third place after chromosomes 1 and X. The best known ones located on it are e.g. loci of the beta-globulin family which are associated with the best known and most widely distributed molecular disease-sickle-cell anaemia and beta-thalassaemia. From knowledge of the causes of these diseases at the genome level so-called DNA diagnostics are derived which can be applied also to the prenatal period. On chromosome 11 are the loci of two complementary groups (C, D) which are extremely sensitive to ionizing radiation--ataxia teleangiectasia, the proinsulin locus the mutations of which, however, are not the cause of common types of diabetes. Development of the urogenital tract as indicated by some of its disorders (WAGR, Denys-Drash syndrome) is controlled by WT genes.
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7788660
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[Problems in placing the abused child in foster home care].
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Children for whom foster parents are found include also abused and battered children. Is such a child able to establish a satisfactory emotional relationship with the foster parents or adoptive parents? The case of a boy repeatedly exposed to cruel corporal punishment in the original family. Attempts of the law court to return the child from a children's home to the original family. Finally complete refusal of the boy by his own parents. Placement of the boy in a new family and his successful adaptation in the new environment.
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7788659
|
[Munchausen syndrome].
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The authors present their own observation of five child patients with Münchhausen's syndrome and Münchausen's syndrome by proxy resp. Both these units are included in the wider framework of the syndrome of the battered child. Four boys and one girl are involved, aged 12-16 years. In all instances the reason for admission to hospital was macroscopic haematuria. The children were prior to hospitalization subjected to a series of various invasive examinations, incl. repeated examinations under anaesthesia to elucodate the cause of macroscopic haematuria. The uncommon course of the "disease" and results of the examinations led in four of the five children to suspicion of Münchhausen's syndrome. Based on this suspicion after immobilization of the patients associated with prevention of manipulation with the hands, macroscopic haematuria disappeared as well as haematuria in general. In the fifth patient Münchhausen's syndrome by proxy was involved. The patient was referred because of repeated attacks of macroscopic haematuria a renal biopsy. The authors analyze in more details the individual case-histories and in the conclusion to they raise their objections to the opinion that these two syndromes are extremely rare.
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7788658
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[2 years' activity of the Crisis Center for Children in the care of battered, abused and neglected children].
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The crisis centre for children in Prague 4-Michle was established as the first workplace to resolve problems of battered, abused and neglected children. Its main task is clinical work with thus suffering children, based above all on a comprehensive, interdisciplinary approach in diagnosis, therapy and rehabilitation and also prevention of this adverse phenomenon in the population. In the course of two years 502 cases were dealt with (on average with 3-4 clients) during 2814 consultations. Most frequently physical and mental abuse was encountered (40%), gross neglect in 17.5% and sexual abuse (in 10%-with a marked relative increase between the first and second year of the activities of the centre). Other problems of child suffering for various reasons (psychiatric or other diseases of the parents, handicapped child, child running away from family etc.) in 32.5%. In addition to clinical work the centre tries to generalize its findings, train workers interested in the above problems, participate in the concept of care of battered children and its implementation in this country.
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7788657
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[Causes of death in fatal cases of child abuse 1964-1988].
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Abuse and/or neglect of children can lead not only to serious health damage but in extreme cases to death. A lethal outcome in the abused child is an incomplete group of seriously damaged children; it, however, makes possible not only numerical comparison but also assessment of trends. The objective of the present work was an analysis of deaths of children who died in conjunction with the use of force in the family. The author analyzed a group of 75 children, 47 boys (63%) and 28 girls (37%) aged less than five years: it covers the period of 25 years (1964-1988) and administrative area of the capital of Prague and former Central Bohemian region with a total number of 2 million population. Newborn babies killed by the mother during delivery or immediately after delivery (63 subjects) were not included in the group. According to analysis by age the following number of deaths was recorded in different groups: 0-1 year 45 deaths (60%), 1-2 years 13, 2-3 years 11, 3-4 years similarly as 4-5 years 3 deaths each. The ratio of boys:girls was 47:28. The most frequent cause of death were head injuries (31-41%), followed by suffocation 15x, injury of abdominal organs 6x, intoxications (4x, incl. 3x carbon monoxide), multiple injuries 4x, injuries of thoracic organis 3x, starvation 2x, hypothermia 2x, thermal damage 1x. The findings on necropsy are not useful only for assessing the cause of death, the mechanism of damage and the time when the damage was inflicted but the spectrum of types of damage can help clinical and social workers in the prevention of the battered child syndrome. Child abuse and neglect in families can lead not only to serious health damage but it can be also fatal. In an area with a population of 2 millions in the course of 1964-1988 75 deaths of children aged less than five years were recorded (ratio: 2.5:1 million per year). Mechanical injuries predominate (89%) in particular head injuries (41%).
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7788656
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[Diagnosis and therapy of child sexual abuse].
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In the crisis centre for children cases of force used on children cumulate, incl. sexually abused children. The interdisciplinary team of the centre is faced with the task to diagnose and treat this phenomenon and with the protection of the child from possible further damage (secondary victimization). In the submitted paper the author analyzes the period from October 1992 to the middle of September 1994, using uniform indicators. Special attention is devoted to psychic and somatic symptoms of the sexually abused child.
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7788655
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[Prevention of child abuse].
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The concept of "child abuse" comprises as a rule physical damage, neglect of the child and sexual abuse of the child. Prevention in the widest sense of the word comprises all three negative social phenomena-in the narrower sense of the word it has for every phenomenon its specific goals, procedures and means. Greatest attention must be paid to primary prevention. The latter has several layers, above all purposeful enlightenment of the public and extensive measures for the benefit of families with children, secondly training and education of primary educators of the child, and thirdly detection of so-called risk groups of the population. From the aspect of prevention we have to take into account the potential risk on the part of the children as well as risk situations in life encountered by children and adults.
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7788653
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[The battered, abused and neglected child and the Crisis Center for Children].
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The syndrome of the battered, abused and neglected child is becoming manifest also in our country with increasing frequency and severity, not only because much more attention is paid to it than ever before. Our system of child care and protection is, however, by far not yet ready to resolve this serious problem in the life of children, families and society as a whole and therefore ways and means must be sought how to face it, how to recognize it, treat it and in particular how to prevent it. One of the important means how to tackle this dangerous social phenomenon is a specialized department concerned in a comprehensive way on an interdisciplinary basis, with skilled and effective clinical work with every single abused child and its family in close association with all disciplines and institutions interested in the problem as well as by conceptual work, research, training and expert opinions etc. The crisis centre for children in Prague 4-Michle wants to serve with its experience and findings as a model workplace for building special institutions within the framework of a rational, interdisciplinary network of child care and protection in this country. The results of its two-year work and the great interest in it on the part of many localities and regions justify its efforts.
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7788654
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[Aspects of genealogy of the use of force on children].
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The quality of the parent-child relationship and the contents of the concept of childhood cannot be separated from the general social situation. The understanding of the child world and its perception of as equivalent to the world of adults is associated as an integral part with humanization and spiritual advances of civilization and depends on the economic standard of society and our ability to understand the spiritual heritage of our civilization. There exists still a deeply rooted mechanism where many families under conditions of stress (social, economic etc.) ventilate their tension and aggressiveness on the child. Battering and abuse of children (except for pathological personality of the parent) is an atavistic remnant of the perception of childhood as a period of incompetence of the individual. The basic manifestations shifted, however, from the transparent and socially tolerated victim of the child to the present--latent and hidden refined "victim" which tortures the child in particular from the mental and emotional aspect. Today we no longer sacrifice the child but much more frequently his childhood. Because of his physical weakness and mental lability even today children are still considered a suitable object for ventilating aggression, temptation to abuse power. In addition to refuting any abuse, battering and neglect of children it must be admitted that this "socially unacceptable behaviour" is encountered less than formerly. An important role is also played by the economic and cultural standard of society. Similarly as certain economic prerequisites are necessary for democracy, economic conditions play an important part in an emancipated concept of childhood and empathic upbringing.(ABSTRACT TRUNCATED AT 250 WORDS)
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7788651
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[The human genome--chromosome 10 and the collagen genes].
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In relation to locuses of the 10th chromosome at present the following are in the focus of interest: tumours of endocrine glands, medullary carcinoma of the thyroid gland (MTC) and multiple endocrine neoplasias (MEN). It seems that the unifying basis is the oncogene RET, responsible for the development of Hirschsprung's disease HSCR. The authors mentions also metabolically important locuses for choline acetyltransferase (CHAT), uriporphyrinogen synthase (UROS) and methyl guanine methyltransferase (MGMT). A special paragraph is devoted to a list of collagenous genes COL1-COL18 and diseases associated with them.
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7788650
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[Simvastatin in the treatment of familial hypercholesterolemia].
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The association between hypercholesterolemia and premature atherosclerosis is almost universally accepted. Treatment of hyperlipoproteinemias represents a reasonable approach in preventive cardiology. The aim of the study was to prove a hypolipidemic effect of simvastatin, Zocor tablets à 10 mg, produced by MSD, U:S.A. in patients with familial hypercholesterolemia. 29 familial hypercholesterolemia heterozygotes have been treated with increasing dose of simvastatin (10 and 20 mg/day with the evening meal) for three months. All patients have been on AHA step I diet. The basic parameters of lipid and lipoprotein metabolism have been measured, as well the concentrations of apolipoproteins A-I and B, and the level of lipoprotein(a). Concentration of total cholesterol decreased after treatment with 10 and 20 mg of simvastatin by 20%, resp. 26%. The hypolipidemic effect was even more pronounced in LDL-cholesterol level, which was reduced by 24% respectively 34%. On the other hand therapy with simvastatin did not influence HDL-cholesterol at all. Also triglycerides concentration did not changed very significantly after administration of simvastatin (triglycerides levels were reduced by 7% respectively by 18%). Decline of LDL-cholesterol has been accompanied by decrease of apolipoprotein B concentration by 24%, resp. 26%. The concentration of lipoprotein (a) has not been statistically significantly influenced, even its level increased slightly. The body weight of the patients did not changed during the study. Simvastatin treatment has been well tolerated by the patients. Simvastatin, Zocor, seems to be powerful hypolipidemic drug, which is to be used even in the treatment of familial hypercholesterolemia heterozygotes, who are usually very resistant to the therapy. The dose of 10 mg of simvastatin is usually sufficient to influence plasma lipids and lipoproteins. A double dose intensifies the hypolipidemic effect but this additional effect is not so expressive. Zocor is tolerated well by the patients and in safety laboratory we did not notice any important undesirable result.
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7788649
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[Decrease in common carotid artery intimal thickness after hypolipemic therapy].
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In recent years evidence was provided that it is possible to assess sonographically the thickness of the intima of the common carotid artery, whereby an increase of the thickness of the intima is considered an early stage of atherosclerosis. In the submitted work the authors tried to assess whether it is possible to influence the thickness of the intima by therapy. In 32 patients with familial hyperlipoproteinaemia sonographic control examinations of the common carotid artery were performed after 27 months of comprehensive treatment. In 21 subjects with familial hypercholesterolaemia the thickness of the intima decreased from 0.83 mm to 0.68 mm (p < 0.01), in 8 subjects with familial combined hyperlipoproteinaemia from 0.77 mm to 0.74 mm (a decline was recorded in half the subjects). In the whole group the greatest decrease was recorded in subjects treated with statins and a smaller decrease in those treated with fibrates. The authors assume that the decrease of the thickness of the intima of the common carotid artery recorded in hyperlipoproteinaemic patients after hypolipidaemic treatment is a manifestation of regression of atherosclerosis.
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7788648
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[DNA cytometry analysis in childhood tumors].
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DNA contents in cells may be determined by flow cytometry. The relationship between malignant cell aneuploidy and prognosis is known in many types of neoplasms in adults and in children. In some situations, demonstration of an aneuploid clone verifies presence of malignant cells. Aneuploidy is rare in benign diseases. This report summarizes our first experiences with cytometric DNA analysis and shows the method's abilities to other potential users. We investigated DNA contents in blood and bone marrow (BM) specimens of 25 children with leukemia, in 41 unfixed solid tumors after biopsy and in 24 specimens of paraffin embedded neuroblastoma tissue. We also investigated 5 specimens of cerebrospinal fluid (CSF) of patients with medulloblastoma, 18 specimens of CSF from patients with leukemia or lymphoma, 4 pleural exudates suspected from malignancies, and 45 specimens of possibly infiltrated BM from primary solid tumors. As the purpose of this study was to test the method on a relatively small number of specimens, we did not perform statistical analysis of our data. As reported previously, aneuploidy was frequent in CALLA + acute lymphoblastic leukemia and in types of neuroblastoma with favorable prognosis (lower clinical stages and less than 2 years of age). Our results show that DNA ploidy may be tested by flow cytometry in an easy and fast way. The source of the material may be unfixed tumors, deparaffinized tumors, BM, blood, CSF and pleural exudates.
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7788645
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Developmental changes in the brain-stem serotonergic nuclei of teleost fish and neural plasticity.
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1. During early ontogeny, the serotonergic neurons in the brain stem of the three-spined stickleback shows a temporal and spatial developmental pattern that closely resembles that of amniotes. 2. However, in the adult fish, only the midline nuclei of the rostral group (dorsal and median raphe nuclei) and the dorsal lateral tegmental nucleus are consistently serotonin-immunoreactive (5-HTir), whereas the groups of the upper and lower rhombencephalon (raphe pontis, raphe magnus, and raphe pallidus/obscurus nuclei) are variable and, when present, contain relatively small numbers of 5-HTir neurons. 3. Using specific antisera against tryptophan 5-hydroxylase and aromatic L-amino acid decarboxylase, we have shown that the lateral B9 group and the groups of the upper and lower rhombencephalon are consistently present in adult sticklebacks. The results are discussed in relation to other known instances of neurotransmitter plasticity or transient neurotransmitter expression in teleost fish. 4. While there are several instances of transient expression of neurotransmitter markers by discrete neuronal populations, there is so far no evidence of changes from one neurotransmitter phenotype to another in the brain of teleost fish. However, there are indications of plasticity of expression of catecholamines and indoleamines, and their respective synthesizing enzymes, as reflected in age-dependent changes and variation between individuals of different physiological status. 5. As the brain grows continuously in teleost fish, and new neurons are added from proliferative regions, synaptic connections may be expected to undergo remodeling in all brain regions throughout life. Thus, the teleostean brain may be considered a suitable model for experimental studies of different aspects of neural plasticity.
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7788647
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[The role of central catecholamines and dopaminergic receptors in the development of estrogen-induced adenohypophyseal hypertrophy].
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Estrogens and thyroid hormones contribute importantly to cell proliferation and tumor transformation in the pituitary gland. The purpose of the present article is provide review about neurotransmitters, chemicals, and receptors that are involved in estrogen-induced anterior pituitary growth. Central dopaminergic and noradrenergic systems are thought to be the most important systems in regulation of pituitary growth and function. For this purpose authors discuss some of their past and present data suggesting that estrogen-induced anterior pituitary pituitary growth is associated with decreased synthesis and metabolism of central catecholamines and increased adenohypophyseal dopamine 2 receptors. Treatment with thyroid hormones prevents both estrogen-induced catecholaminergic inhibition and dopamine D2 receptor increment in the anterior pituitary gland. Further studies focusing on central catecholaminergic systems, pituitary receptor equipment and mechanisms of intracellular signal transduction will be of value to better understand pituitary tumor formation and possibly to find new approaches toward treating patients with these tumors.
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7788646
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[Free radicals in the pathogenesis of selected diseases].
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Free radicals are chemical substances which contain one or more unpaired electrons, which is the cause of their high reactivity with a series of biologically important substances such as fatty acids, DNA, RNA, amino acids. The source of radicals are immunological reactions and reactions in the endoplasmatic reticulum during detoxication of xenobiotics. Free radicals can act on the organism by a number of reactions, the most frequent on being lipid peroxidation when important toxic products are formed such as 4-hydroxy 2,3 trans-nonenal (4-HNE) and malondialdehyde. Direct assessment of free radicals due to their short life span is difficult in clinical practice. The majority of measurements is based on the assessment of substances which are formed by the reaction of free radicals in the organism. The most frequent method is assessment by means of thiobarbituric acid. Oxidative stress (the reaction produced by the action of free radicals) of tissues and cells is caused by the increased formation of free radicals and/or reduced capacity of antioxidant systems. Free radicals are involved in the process of ageing, cancerogenesis, inflammatory and degenerative diseases, atherogenesis, and play a part in the ischaemic and toxic damage of the organism. During evolution antioxidant defence mechanisms developed which under physiological conditions are sufficient to inactivate free radicals. Antioxidant systems can be divided into two groups--antioxidant enzymes (superoxide dismutase, glutathione peroxidase, catalase etc) and antioxidant substrates (tocopherols, carotenoids, ascorbic acid, glutathione, transferrin, ceruloplasmin etc).
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7788643
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Heterogeneity and differential expression of the gamma-aminobutyric acidA (GABAA)/benzodiazepine receptor in the avian brain during development.
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1. The changes in the GABAA/benzodiazepine receptor in chicken brain during development has been studied by using 3H-flunitrazepam as the probe for the benzodiazepine modulator site and the antibodies recognizing the receptor protein. In the telencephalon and optic tectum, the proteins of 48, 50, and 51 kD were markedly labeled by 3H-flunitrazepam from embryonic day 18 to postnatal days, as revealed by photoaffinity labeling and SDS-PAGE of the brain membranes; the 51-kD protein appeared to be the predominant one in labeling intensity except at embryonic day 18 and postnatal days 14 and 28, whereas the 47- and 50-kD proteins were dominant in the cerebellum. However, the 47- and 48-kD proteins were faintly seen after postnatal day 28 in the three regions examined. 2. Immunoblotting using a monoclonal antibody against the 50- and 51-kD proteins showed that the straining pattern in the developing telecephalon or optic tectum was similar to the 50 kD/51 kD pattern obtained from fluorography. The antibody also stained the 50- and 51-kD proteins in the cerebellum despite the fact that the 51-kD protein was barely seen in the fluorogram. Moreover, the 50-kD protein was recognized by an antiserum raised against a partial sequence of the alpha 1 subunit of the receptor expressed in bacteria. The staining levels for the 50-kd protein by the antiserum on immunoblots of the brain regions were low in embryonic animals but higher during postnatal stages, consistent with that seen in fluorograms. 3. Receptor binding autoradiography using 3H-flunitrazepam exhibited that varying degrees of labeling intensity occurred among various brain areas at different ages. High densities of binding were present in the olfactory bulb, paleostriatum, optic tectum, and midbrain. These results support the diversity of the GABAA/benzodiazepine receptor in the vertebrate CNS.
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7788644
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Midazolam and the N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-7-phosphonoheptanoic acid (AP-7) attenuate stress-induced expression of c-fos mRNA in the dentate gyrus.
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1. The effects of restraint stress on c-fos mRNA expression in the dentate gyrus were investigated by in situ hybridization. 2. Confirming previous findings, c-fos mRNA expression increased after 30 min of forced restraint. 3. This effect was attenuated by a previous i.c.v. injection of the anxiolytic benzodiazepine midazolam (20 nmol/2 microliters) or the N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-7-phosphonoheptanoic acid (AP-7; 5 nmol/2 microliters). 4. These results suggest that the dentate gyrus is activated during restraint stress and that this activation may be modulated by benzodiazepine gamma-aminobutyric acidA (GABAA) or NMDA receptors.
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7788642
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Selective postmortem degradation of inducible heat shock protein 70 (hsp70) mRNAs in rat brain.
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1. Altered mRNA levels in postmortem brain tissue from persons with Alzheimer's disease (AD) or other neurological diseases are usually presumed to be characteristic of the disease state, even though both agonal state (the physiological state immediately premortem) and postmortem interval (PMI) (the time between death and harvesting the tissue) have the potential to affect levels of mRNAs measured in postmortem tissue. Although the possible effect of postmortem interval on mRNA levels has been more carefully evaluated than that of agonal state, many studies assume that all mRNAs have similar rates of degradation postmortem. 2. To determine the postmortem stability of inducible heat shock protein 70 (hsp70) mRNAs, themselves unstable in vivo at normal body temperature, rats were heat shocked in order to induce synthesis of the hsp70 mRNAs. hsp70 mRNA levels in cerebellum and cortex were then compared to those of their heat shock cognate 70 (hsc70) mRNAs, as well as to levels of 18S rRNAs, at 0 and at 24 hr postmortem. 3. Quantiation of northern blots after hybridization with an hsp70 mRNA-specific oligo probe indicated a massive loss of hsp70 mRNA signal in RNAs isolated from 24-hr postmortem brains; quantitation by slot-blot hybridization was 5- to 15-fold more efficient. Even using the latter technique, hsp70 mRNA levels were reduced by 59% in 24-hr-postmortem cerebellum and by 78% in cortex compared to mRNA levels in the same region of 0-hr-postmortem brain. There was little reduction postmortem in levels of the hsp70 mRNAs or of 18S rRNAs in either brain region. 4. In situ hybridization analysis indicated that hsp70 mRNAs were less abundant in all major classes of cerebellar cells after 24 hr postmortem and mRNAs had degraded severalfold more rapidly in neurons than in glia. There was no corresponding loss of intracellular 18S rRNA in any cell type. 5. We conclude from these results that the effect of postmortem interval on mRNA degradation must be carefully evaluated when analyzing levels of inducible hsp70 mRNAs, and perhaps other short-lived mRNAs, in human brain.
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7788641
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Concomitant protein phosphorylation and endogenous acetylcholine release induced by nicotine: dependency on neuronal nicotinic receptors and desensitization.
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1. Nicotine stimulated two Ca(2+)-dependent processes in rat frontal cortex synaptosomes: the phosphorylation of an 80-kDa protein band and the release of endogenous ACh.3 Both effects were mediated by neuronal nAChRs and coincided with depolarization of the synaptosomal plasma membrane induced by the drug. Changes in the state of phosphorylation of the 80-kDa band (presumed to contain synapsin I) were correlated with changes in the release of ACh as follows, from 2 to 4. 2. Blockade of predominant, nerve terminal P-type Ca2+ channels with omega-agatoxin-IVA, did not prevent nicotine from stimulating ACh release. In contrast, exposure to the toxin partially inhibited the release promoted by the depolarizing agent veratridine and attenuated protein phosphorylation induced by either nicotine or veratridine. Taken together, these data suggest that, upon nicotine stimulation. Ca2+ enters nerve terminals through two distinct pathways. The first, via Ca2+ channels, is necessary (but not sufficient) for both nicotine-induced phosphorylation and ACh release. The second, both necessary and sufficient for nicotine-induced phosphorylation and release, is the neuronal nAChR itself. 3. Preincubation of the synaptosomes with a subeffective concentration of nicotine inactivated both nicotine-induced ACh liberation and phosphorylation. This shows that diminished release is associated to decreased phosphorylation of the 80-kDa protein band, most likely as a consequence of nicotine-promoted nAChR desensitization. 4. Augmented ACh release and phosphorylation of the 80-kDa protein band were achieved by using the protein phosphatase inhibitor okadaic acid. However, okadaic acid did not summate with either nicotine or veratridine to increase ACh release further. This is probably because okadaic acid, as in other neurons, increases intracellular Ca2+ (Cholewinski et al., 1993), thus promoting desensitization of ACh release.
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7788640
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Effect of ionophores on the processing of the beta-amyloid precursor protein in different cell lines.
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1. Alzheimer's disease is characterized by the deposition in the brain of extracellular amyloid plaques and vascular deposits consisting mostly of amyloid beta-peptide (A beta). A beta, a polypeptide of 39-43 amino acids (M(r), approximately 4 kDa), is derived proteolytically from a family of proteins of 695-770 amino acids (M(r), approximately 110-140 kDa) called beta-amyloid precursor protein (beta APP). 2. beta APP, an integral membrane glycoprotein, is extensively posttranslationally modified within the endoplasmic reticulum (ER) and various Golgi compartments. beta APP is cleaved by proteases in either the trans-Golgi network or the post-Golgi apparatus and then secreted as a truncated soluble form into the conditioned media of cultured cells and cerebrospinal fluid samples from human subjects. beta APP can be processed either by an antiamyloidogenic secretory pathway or by an endosomal/lysosomal pathway. 3. I studied the effect of two ionophores on the processing of beta APP in cultured cells. Monensin and, in some cases, ammonium chloride increase the intracellular accumulation of beta APP in several cell lines and may alter its processing. Monensin, which had the most consistent effects, also inhibited secretion of beta APP in a differentiated (growth factor mediated) cell line. Nigericin, with greater K+ selectivity, was less able to alter the accumulation and possible processing of the protein. 4. These results suggest that the increase in the accumulation of intracellular beta APP observed after treating cells with ionophores has some specificity. The selective effect of these ionophores on the metabolism of beta APP may provide a model system to analyze the pathways for studying maturation, secretion, and degradation of beta APP.
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7788639
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Hemiazygos continuation of a left inferior vena cava draining into the right atrium via persistent left superior vena cava: demonstration by helical computed tomography.
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We report an unusual case of hemiazygos continuation of a left inferior vena cava draining into the right atrium via the persistent superior vena cava. Spiral computed tomography (CT) showed the course and the flow direction of this vena caval anomaly in a real-time manner, obviating conventional venography.
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7788638
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Use of a cutting balloon for dilatation of a resistant venous stenosis of a hemodialysis fistula.
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In a 71-year-old patient with a Brescia-Cimino hemodialysis fistula, high-pressure balloon dilatation failed to open the stenosis completely and a constant waist of the balloon was found. The use of a 3.5-mm coronary cutting balloon (Barath balloon) was helpful in preparing the stenosis for subsequent successful dilatation.
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7788637
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Percutaneous retrieval of a surgical laparotomy sponge from the peritoneal cavity.
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Percutaneous retrieval of an extravascular foreign body is an uncommon procedure. This report describes the successful retrieval of a 46 x 46-cm laparotomy sponge from the peritoneal cavity using a Nitinol Gooseneck Snare system. This technique can eliminate the need for exploratory surgery and may be particularly useful in poor operative candidates.
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7788636
|
Embolization of a ruptured middle colic artery aneurysm.
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Middle colic artery aneurysms are very uncommon. A few cases of occlusion of superior mesenteric artery aneurysms without bowel ischemia are reported. We describe successful uncomplicated embolization of a ruptured middle colic artery aneurysm with a Gelfoam plug.
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7788635
|
Wallstent misplacement into the paraumbilical vein during TIPS from the left hepatic vein: correction by placing a second stent through the mesh of the first stent.
|
During a TIPS procedure using the left hepatic vein approach, a Wallstent was misplaced into a dilated paraumbilical vein instead of the left portal vein. The correct shunt direction from the left portal vein to the left hepatic vein was restored by coaxially inserting a second Wallstent through the stretched mesh of the misplaced stent. To prevent such stent misplacement, it seems useful to emphasize the importance of maintaining the exchange guidewire within the distal portion of the splenic or mesenteric vein throughout dilatation and stenting of the liver parenchyma.
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7788634
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A new use of the Simpson percutaneous atherectomy catheter: resection of retained valve cusps of an in-situ vein graft.
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An in-situ saphenous vein graft occluded because of retained valve cusps. After aspiration thrombectomy, percutaneous transluminal balloon angioplasty was performed, but reocclusion occurred 11 months later. Following a second aspiration thrombectomy, the restenosed retained cusps were resected using the Simpson percutaneous atherectomy catheter. The graft remained patent until the patient's death from unrelated causes 6 months later.
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7788633
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Percutaneous hepatic venous reanastomosis in a patient with Budd-Chiari syndrome.
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A 33-year-old woman with Budd-Chiari syndrome for 9 years presented with worsening right upper quadrant pain and progressive liver dysfunction. Hepatic venography demonstrated hepatic vein occlusions, without significant IVC obstruction. Attempts at stenting a stenotic middle hepatic vein were unsuccessful. Transjugular access, however, allowed puncture from the stump of the right hepatic vein into the engorged right intrahepatic vein that had been demonstrated by retrograde hepatic venography. Two Palmaz stents were used to form the veno-venous reanastomosis. Initial success was documented angiographically and by pressure measurements before and after shunting. Followup at 7 and 16 months confirmed patency of the anastomosis without intimal hyperplasia. The patient noted near-complete resolution of her pain, and her liver function stabilized.
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7788632
|
Chronic aortoiliac dissection treated by self-expanding stent placement.
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A 47-year old male patient presented with claudication from a right-sided aortoiliac dissection secondary to transfemoral cardiac angiography. Placement of two self-expanding stents led to immediate compression of the false channel. The patient has been free of symptoms for 18 months.
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7788631
|
Persistent iliac endarteritis with pseudoaneurysm formation following balloon-expandable stent placement.
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We present a patient who developed endarteritis and pseudoaneurysm formation complicating iliac artery stent placement. Blood cultures grew Staphylococcus aureus. Three weeks after antibiotic treatment, the aortic bifurcation and the stents were removed, together with the left common iliac artery pseudoaneurysm. As with any other implantable device, septic complications are dreaded and should be recognized and treated early. Consideration may be given to the use of appropriate prophylactic antibiotics.
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7788629
|
Transcatheter arterial embolization as a method of cisplatin-retention enhancement on the VX2 tumor uterus transplants.
|
Enhanced cisplatin (Pt) retention using transcatheter arterial chemoembolization (TAE) with Gelfoam particles was studied in rabbit uterine tumors. Ten rabbit uteri were inoculated with 5 x 10(7) cells of VX2 carcinoma. Three to four weeks later cisplatin, 1 mg/kg, was injected, either with (TAE group) or without (IA group) being mixed with small Gelfoam particles, into the aortic bifurcation over 5 s. Blood and tissue concentration of cisplatin were determined. Slower arterial blood clearance of Pt was observed in the TAE group compared with the IA group, whereas the venous blood Pt clearance curves were similar for both groups. The uterine tumor Pt concentration at 80 min was found to be 2.52-fold higher after TAE compared with IA (p < 0.01). In the pelvic metastatic lymph nodes, the Pt concentration was 4.63 times higher after TAE than after IA (p < 0.01). These data indicate that TAE is an effective means of increasing tissue concentration in uterine tumors.
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7788630
|
Analysis of particle size generated during plaque ablation with a flashlamp pumped pulsed dye laser.
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To examine debris size generated during in vitro plaque ablation by laser energy and estimate the risk of peripheral embolization following laser angioplasty. A flashlamp pumped pulsed dye laser of 480-nm wavelength was used to ablate calcified arteriosclerotic plaque, fibrous fatty plaque, and normal aortic wall on samples of human cadaver aortas. Each tissue sample was immersed in saline solution and treated with the same amounts of laser energy transmitted by a 320 microns-diameter glass fiber in direct tissue contact. The debris generated during plaque ablation was then separated from the supernatant and the particles were counted and analyzed for size. Depending on the underlying type of tissue and the setting of laser energy, a wide range of particles with sizes between 5.3 mm2 and 64 microns 2 was found in samples. The largest particles were found after ablation of calcified atherosclerotic plaque, whereas fibrous, fatty plaque and normal aortic wall showed smaller particles and a lesser amount of debris. Our study demonstrates that a considerable amount of debris is generated during laser angioplasty at 480 nm and that particle size is sufficient to cause potentially symptomatic embolic occlusions of mid- and small-sized peripheral arteries.
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7788628
|
Malignant biliary obstruction treated by Wallstents and Strecker tantalum stents: a retrospective review.
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To evaluate retrospectively the role and the effectiveness of self-expandable Wallstents and balloon-expandable Strecker stents in patients with inoperable malignant obstruction of the biliary tree. Fifty patients with malignant biliary obstruction were treated from August 1991 to August 1992 by percutaneous placement of 55 metallic endoprostheses (39 Wallstents, 16 Strecker stents). All patients were followed by clinical evaluation, laboratory data, and ultrasonographic examination until death. Wallstent placement was successful in 36 patients without procedure-related complications. One partial occlusion after 1 year was resolved by percutaneous balloon dilatation. Fourteen patients were treated with 16 Strecker stents. Stenting was unsuccessful in four cases; four occlusions (after 6 h, 48 h, 2 and 6 months) were encountered. Wallstent endoprostheses have good results and long-term patency. There were some problems with Strecker stents during the placement and there was a higher occlusion rate.
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7788627
|
Iatrogenic dissection of the celiac artery and its branches during transcatheter arterial embolization for hepatocellular carcinoma: outcome in 40 patients.
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To study the sequelae of iatrogenic dissection of the celiac axis and its branches in a large patient population. We analyzed 40 patients with hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected during transcatheter arterial embolization (TAE) and underwent follow-up angiography within 2 months. The two most common sites of dissection were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11 patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5% (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries recanalized. Pseudoaneurysm formation of the dissected artery was observed in 32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79% (27/34) of patients in this series. Iatrogenic dissection of the celiac and proximal hepatic arteries heals spontaneously in the majority of patients, and in most instances allows subsequent TAE.
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7788626
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Laser angioplasty of peripheral arteries: an epilogue?
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This review gives a short overview of the results of 15 years of experimental and clinical work on laser angioplasty. Experimentally, photothermal and photomechanical ablation of plaque could be demonstrated. However, laser angioplasty did not cause reduction of platelet adhesion and intimal hyperplasia. Clinically, the technique of laser angioplasty was continuously improved until the initial recanalization rates and long-term patency rates in femoropopliteal artery occlusions were the same as the success rates of percutaneous transluminal angioplasty (PTA). This was proven by various randomized studies. Currently, laser angioplasty cannot be proposed as a routine procedure because it is an expensive technology. However, laser recanalization and debulking of total occlusions should be further developed, especially in combination with endoluminal graft placement.
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7788625
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Evidence-based psychiatry.
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To apply the evidence-based medicine paradigm to the domain of psychiatric practice and to bring out the consequences for psychiatry of this approach in order to foster the emergence of an evidence-based psychiatry. The basic assumptions of traditional and evidence-based paradigms, as delineated by the Evidence-Based Working Group, are used to structure an exploration of the evidence-based approach to psychiatry. Theoretical and practical issues are considered and an example of evidence-based decision making is given. An evidence-based approach to psychiatry is described as one that emphasizes the importance of systematic observation and the use of rules of evidence in hypothesis testing. It is suggested that psychiatrists using this approach will be in a position to provide superior patient care. The application of scientific method to psychiatric problems is discussed as the essence of an evidence-based approach. The common error of "scientism" is described. The authors identify advantages and limitations of an evidence-based approach to psychiatric practice and advocate a decision-making process that balances individualized clinical acumen (phronesis) and information derived from empirical study of groups of patients (techne).
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7788624
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Neuroendocrine assessment of serotonin (5-HT) function in chronic fatigue syndrome.
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Prolactin and cortisol responses to dl-fenfluramine challenge were examined in 11 patients with chronic fatigue syndrome and in 11 healthy controls who were age and gender matched. After obtaining two baseline samples, each subject was given 60 mg of dl-fenfluramine orally and further blood samples were drawn hourly during the following five hours in order to measure prolactin and cortisol levels. There was no difference in either baseline or fenfluramine-induced hormonal responses between patients with chronic fatigue syndrome and controls. There was also no correlation between depression scores on HAM-D and hormonal responses in patients with chronic fatigue syndrome. The findings of this study do not support a role for 5-HT in chronic fatigue syndrome.
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7788623
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Behavioural inhibition, attachment and anxiety in children of mothers with anxiety disorders.
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This study examined the relationship between behavioural inhibition, insecure mother-child attachment and evidence of anxiety in the offspring of mothers with anxiety disorders. Twenty children aged 18 to 59 months who were born to 18 mothers with diagnosed anxiety disorders were examined for behavioural inhibition (Kagan's measures) and mother-child attachment (Strange Situation Procedure). Child anxiety was assessed using DSM-III-R criteria and the Child Behavior Checklist (CBCL). Sixty-five percent of the children were behaviourally inhibited. They showed more somatic problems and fewer destructive behaviours than those who were not inhibited. Eighty percent of the children were insecurely attached. They had higher CBCL internalizing scores than secure children and three of them met diagnostic criteria for anxiety disorders. Though preliminary, this work suggests a need to identify children of anxious mothers as being at risk for anxiety, especially in the presence of inhibited temperament or attachment difficulties.
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7788622
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Screening for post-partum depression in a community sample.
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This study undertook to estimate the prevalence of post-partum depression in the community by means of telephone screening. Demographic correlates of post-partum depression were also investigated. The sample was identified through two community health centres. Over a period of 17 months, 1559 childbearing women were screened at six weeks post-partum, using the ten-item Edinburgh Postnatal Depression Scale (EPDS). The prevalence of post-partum depression was estimated to be 6.2%, using a cut point of 10 on the EPDS, and 3.4% using the more stringent cut point of 12. Women who were not working or those with lower occupational status, were at greater risk for depression. Recent immigrants, particularly those who were not working or who had given birth to a second child, were also at higher risk. Telephone screening for post-partum depression is feasible, and can aid in the identification of women at risk.
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