[Hereditary hypertension in Recklinghausen's disease during pregnancy. A family].

We report the case of a pregnant woman who presented with neurofibromatosis and hypertension the latter revealed by abruptio placentae. Severe hereditary hypertension was noted in the family during pregnancies that were sometimes complicated by intrauterine growth retardation, abruptio placentae and intrauterine foetal death. Thus, neurofibromatosis in a pregnant woman has a poor obstetrical outcome when it is associated with a personal or family history of hypertension. Such women must be treated with extreme care and hospitalized at the end of the third trimester. The advisability of prevention with low-dose aspirin during the first trimester is discussed.


[Circulatory assistance through cardiomyoplasty and aortomyoplasty. Experience and first clinical results].

The finding that skeletal muscles can be made resistant to fatigue by progressive electrical stimulation has been used as a means of providing circulatory support in cardiac surgery. The first application of this discovery was dynamic cardiomyoplasty, performed for the first time in man in 1985 at the Broussais Hospital, Paris. The latissimus dorsi muscle is transposed into the thorax, then attached around the heart and finally stimulated synchronously with the ventricular systole. So far, more than 200 patients in the whole world (including 57 at the Broussais Hospital) have undergone this operation with results that are increasingly encouraging. In these cases the muscle is used to reinforce or replace the left or right ventricle, but other applications are being studied, such as double cardiomyoplasty (left latissimus dorsi and right pectoralis major muscles), cardiomyoplasty of the right atrium and aortomyoplasty which produces aortic counterpulsation. The development of these techniques underlines the ever growing interest raised by this type of autologous circulatory support.


Provoking vasodepressor syncope with head-up tilt-table testing.

Head-up tilt testing has proven effective in identifying individuals prone to vasodepressor syncope (VDS). VDS refers to the transient loss of consciousness/cerebral anoxia seen with hypotension produced by autonomic imbalance. In this case, the hypotension is the result of parasympathetic domination. Most episodes appear to be triggered by reduced venous return which stimulates the cardiac mechanoreceptors in the inferior-posterior left ventricle. Once activated, these receptors send out afferent signals along the unmyelinated C of the vagus nerve and cause vasodilation. Once venous return is restored, the usual sympathetic compensations (increased heart rate/force of contraction and vasoconstriction) overcome the parasympathetic domination. A tilt-study allows one to passively tilt the patient up to 40-80 degrees and abruptly reduce venous return in a controlled environment. One can then determine which mechanism will dominate--the usual sympathetic vasoconstriction or the parasympathetic reflex (Bezold-Jarisch)--by frequent observations of blood pressure and ECG. Bradycardia/ventricular standstill may also occur during parasympathetic domination. Once susceptibility to vasodepressor syncope is identified by a tilt study, medications to expand the blood volume and/or minimize venous pooling are often needed. Other drugs to block the parasympathetic pathway and/or the effects of excessive catecholamine levels may also be ordered. Dual chamber pacing may be required for malignant episodes of bradycardia or ventricular standstill.


Pregnancy after heart transplantation.

The desire to procreate is normal in women, including those who are heart transplant recipients. The female transplant recipient attempting successful conception, pregnancy, and delivery presents a rare challenge to those responsible for her care. This article presents a comprehensive review of pregnancy after heart transplantation in female recipients by reviewing relevant literature, describing the effects of immunosuppressive therapy on reproduction, and suggesting strategies for reproduction counseling.


Regulation of the cerebral circulation by endothelium.

Endothelium exerts an important influence on cerebral vascular tone through the production and release of a diverse group of vasoactive factors. Relaxing factors produced by endothelium include nitric oxide (or a nitric oxide-containing compound), a hyperpolarizing factor, and prostacyclin. Endothelium-derived contracting factors include cyclooxygenase products of arachidonic acid and endothelins. Several pathophysiological conditions are associated with increased formation of endothelium-derived contracting factors. Such endothelial dysfunction in the cerebral circulation may shift the balance of vascular tone toward constriction and may potentially contribute to the onset or maintainance of cerebral ischemia and stroke.


Experiences of patients and significant others with automatic implantable cardioverter defibrillators after discharge from the hospital.

Sudden cardiac death (SCD) is a leading cause of mortality in this country. The automatic implantable cardioverter defibrillator (AICD) is a technology which has proven successful in reducing the risk of SCD in patients who qualify for it. However, little is known about how individuals adjust to living with the device. This field study used a focus group technique to investigate the question "What are the experiences of patients and their significant others (S.O.) in the time since being discharged from the hospital with an AICD?" Fifteen AICD recipients and 14 S.O.s each attended one of three focus groups which were tape recorded. Data from the transcriptions were analyzed by a combination of content analysis and ethnographic summary. The major concerns of the patients were [Physiologic], the sensations of being shocked, medications, trouble sleeping, dizziness (accompanied by heat intolerance at times), physical awareness of the device; [Psychosocial], fear, including fear of death and preparation for death, changes in mental functioning, changes in lifestyle including clothing not fitting, loss of control, driving an automobile, and spousal overprotectiveness. The primary psychosocial concerns of the S.O.s were fears, including fear of death and preparation for death, family and role changes, being overprotective and driving an automobile. Mental changes and heat intolerance have not been addressed in the literature previously.


Rhythms and the pharmacology of lithium.

Lithium is the treatment of choice for bipolar affective disorder (manic-depression) and is useful in other recurrent affective and nonaffective illnesses. This review discusses lithium's actions on period, phase, amplitude and coupling of biological rhythms that may relate to its therapeutic effectiveness. Alternatively, lithium might interact with environmental light to influence circadian rhythms by an action on the retina. The mechanisms responsible for lithium's chronopharmacological actions are not known, but cellular cations, phosphoinositide or adenylate cyclase second messenger systems, hormones and neurotransmitters may all be involved.


Caring for a Marfan patient with cardiovascular complications.

The Marfan syndrome is a heritable disorder of connective tissue associated with characteristic abnormalities of the skeletal, ocular and cardiovascular systems. Common cardiovascular manifestations of this syndrome are mitral valve prolapse with mitral regurgitation and dilatation of the ascending aorta resulting in aortic insufficiency, dissection, aneurysm and/or rupture. Although the prognosis for a patient with the Marfan syndrome is significantly more favorable than it was ten years ago, the cardiovascular complications continue to greatly reduce life expectancy. This article presents an overview of the Marfan syndrome including: history and epidemiology, clinical manifestations, diagnostic criteria, surgical intervention and follow-up. A case study is outlined which focuses on priority nursing diagnoses and a plan of care.


Beta A4 amyloid protein and its precursor in Alzheimer's disease.

The beta A4 amyloid protein is now understood to play a pivotal role in the development of Alzheimer's disease. This protein is generated by the abnormal processing of the amyloid protein precursor, a large membrane glycoprotein. Insights into the mechanisms of this abnormal processing will give information relevant to the design of new therapeutic strategies for Alzheimer's disease.


[Comparative in vitro susceptibility of clinical bacterial isolates to pefloxacin and 14 antibiotics].

In vitro activity of pefloxacin against 782 bacterial strains isolated from hospitalized patients (July-September 1991) in Wrocław was compared with that of 14 antibiotics (4 aminoglycosides and 10 beta-lactamase). The most susceptible to pefloxacin were: Staphylococcus epidermidis (96.0%), Klebsiella (94.4%), Proteus mirabilis (93.8%) and Escherichia coli (92.7%). The least susceptible proved to be: nonfermentative Gram-negative rods (46.5%), and among them Pseudomonas aeruginosa (19.3% weakly sensitive, 0% sensitive strains). It was found that over 80% of Gram-negative rods were susceptible to pefloxacin, amikacin, netilmicin, cefotaxime and ceftriaxone. The most active against staphylococci were netilmicin (92.6%), pefloxacin (89.4%) and amikacin (82.5%).


[Nodular intrabronchial changes in primary tuberculosis of children in the years 1986-1990].

Seventy-seven bronchoscopies have been performed and evaluated in twenty-eight children, aged five months to thirteen years suffering from primary tuberculosis. Endobronchial lesions have been found in 57.1% of the cases. Out of them, broncho-nodular fistula was seen in 32.1% of the cases. It has been found out that the frequency of occurrence of this kids of lesions in the actual epidemiological situation is similar that diagnosed several decades ago.


[Death in the context of obstetric nursing: perspectives of care].

The authors intend to unveil facets of the meaning of mother's care who has lost her baby at the end of pregnancy, in the nursery labor view. For that, they used a Qualitative Research Methodology. The phenomenological methodology of inquiry allowed them to reach the subject of the study. The data were collected from obstetric office employees that answered a guiding question. The analysis of these answers reveals important points linked to this mother's care.


[The learning needs of laryngectomized patients].

This study reports the learning needs of laryngectomized patients from a university hospital. The data about how the patients feel about their post surgical condition, were obtained by participant-observation. The patients words were collected in case-studies and related to the learning needs. On the basic of these needs the authors intend to plan the pedagogic action.


[Living with an ostomy: a preliminary study].

This study reveals some aspects of ostomy patients life experience. The data were obtained by using the participant observation technique during the monthly meeting session of the Ostomy Patients Association from July 1989 to August 1991. The findings showed that the ostomized patients were concerned with: 1) the ostomy pouch (how to get it); 2) other persons opinion about ostomized patients; 3) their sexuality, and stoma care. The patients perceived themselves as physically disable and inferior persons. Some of them perceived themselves as having a normal life. Other patients also had to cope with the stigma of cancer.


[Care: a theoretical review].

This paper focuses on the theoretical review of care and caring in Nursing and other fields, as to meaning, concepts, and perspectives. Care is the essence of Nursing and the author suggests the study and practice of care/caring in the Nursing community, considering the Brazilian reality.


[An organizational model of nursing service].

This study approaches how important is a nursing organized service to achieve effectiveness. The author proposes a Nursing service organization model containing items such as: philosophy, goals, internal regiment and policies, divided in directive structure, budget human and material resources, teaching, research and nursing assistance.


[Intracavity brachytherapy in uterine neoplasms].

The growing use of intracavity treatment of uterine neoplasia has not been accompanied in the Brazilian literature by articles appropriate for day-to-day consultation. Based on this fact we endeavour to transmit in this paper our experiences related to this therapy technique.


[Introducing the human existential dimension into a course on nursing fundamentals].

The study consisted of one historical retrospect of how the course Fundamental of Nursing is being oriented in man focus and the of assistance of nursing given to him. It describes and analyses an experience which has been realized by teachers of course Fundamental of Nursing in the Nursing School of Ribeirão Preto at University of São Paulo. It consists of the philosophical approach about the man who we assist. Consolidate with the Heidegger's ideas, we introduce the man's notions of being-in-the-world-with-the-others, of hospital and disease world and the facets, enabling to see the man as sick, in his-being-sick, as the new perspective of comprehension of human existence.


[The teaching of primary health care: diagnostic and educational evaluation by microcomputers].

The study aims to explore the utilization of the Formative Evaluation by the microcomputer in the teaching of primary attention to the health. The experiment is composed of eight modules, programmed in Basic software "Formative Evaluation". For each module, a "Question Bank" with three sorts of feedbacks was organized. The sample includes 16 subjects. The results show that the Formative Evaluation by Microcomputer proportioned to the students a cognitive domain significantly higher than the traditional instruction. However, it didn't provide a significantly superior performance to the students who experienced this system.


[Reproductive cycle of the pocket gophers Orthogeomys cherriei (Rodentia: Geomyidae) in Costa Rica].

Pocket gophers (Orthogemys cherriei) is a pest in agriculture in Limón, Costa Rica; 232 animals were trapped in several farms. They reproduce continuously throughout the year. Adults of both sexes are found in reproductive condition at any time. The females produce at least 2 litters per year (1-4 newborns each). There is no correlation between position of testes and production of sperm. The position of the testes is not a reliable factor to establish the reproductive condition in males. There is a correlation between length of os penis (baculum) and length of the testes, irrespectively of its reproductive condition. These pocket gophers disperse above-ground.


[Effect of corticosteroids on the congenital transmission of experimental toxoplasmosis].

Female white mice with chronic toxoplasmosis were treated with cortisone acetate (3mg for each 25 g of body weight) 12, 8, 4 and 0 days before mating. Cortisone induces congenital transmission of T. gondii.


[Cytotoxicity induced by Peruvian snake venom on fibroblasts of mice].

The cytotoxic effect of venoms from six crotalinae Peruvian snakes (Bothrops atrox; B. brazili; B. pictus; B. barnetti; Lachesis m. muta y Crotalus durissus terrificus) was studied in an in vitro system of BALB/c 3T3 fibroblasts grown in Dulbecco modified minimal essential medium at 37 degrees C in a humidified atmosphere of 5% CO2-95% air. The viability of the cells was evaluated 24 hours after the treatment with the different venoms, using the method of exclusion of trypan blue. The six venoms produced cytotoxic effects at 24 hours on the 3T3 fibroblasts. The venom from B. atrox was the most potent (DE50 = 162 ng/ml) and that from B. barnetti the least (DE50 = 7182 ng/ml).


Sexual differences in the brain catecholamine content in four species of tropical bats.

The catecholamines dopamine, norepinephrine and epinephrine were studied in the brains of male and female tropical bats of four species, with different feeding habits (insectivorous, frugivorous, omnivorous and pollen eater). They were trapped in a refuge at 18 degrees 24'24''N, 99 degrees 02'08''W with a mean annual temperature of 25.8 degrees C, in a tropical deciduous forest. The three catecholamines occur in both sexes of all four species, in levels which are statistically different among species as well as between sexes. Dopamine and norepinephrine levels were higher in males than females, but the opposite occurs with epinephrine. These findings suggest that changes in catecholamine levels are intimately involved in the reproductive pattern of the species studied.


[Chemico-nutritional composition of meat of Strombus galeatus (Mesogastropoda: Strombidae)].

Strombus galeatus samples were collected in Lagarto (10 degrees 06'N,85 degrees 48'W), Bahía Ballena (9 degrees 42'N,85 degrees 01'W) and Golfito (8 degrees 30'N,83 degrees 10'W) at the Pacific coast of Costa Rica. Individual weight ranged between 141.9 and 241.3 g (41.3-65.6% edible). Over 72% is water, 23% protein and 3% ash. The caloric content varied between 126.5 and 129 kcal/100g. Fat, crude fiber and carbohydrates contents were small. Mean ranges (%) in minerals were: 403.0-465 P, 233.5-315.7 Ca, 89.7-315.0 K, 122.3-145.5 Na, 217.5-266.3 Mg, 1.5-5.3 Fe, 2.0-8.7 Zn and 0.2-0.5 mg % Cu. As was not detected, and the Cd and Pb contents were 0.046-0.062 and 0.19-0.21 mg/kg, respectively. Concentrations of heavy metals in the meat are not toxic for humans.


[Hematologic values and serum enzymes in horses inoculated with snake venoms for the production of antivenins in Costa Rica].

Blood components were studied in six horses immunized with snake venoms for the production of polyvalent antivenom in Costa Rica. No significant changes in hemoglobin or hematocrit throughout the immunization period were observed, whereas a significant increment in total serum proteins occurred in the second half of the immunization process, probably due to an increased synthesis of immunoglobulins. There were no significant changes in creatine kinase, but a slight increment was detected in both transaminases, although they did not exceed normal limits. These findings suggest the absence of relevant tissue damage in skeletal muscle, cardiac muscle and liver. In agreement with these results, horses did not develop signs of systemic poisoning, presenting only minor alterations at the site of venom injection, such as oedema, abscesses and fistulas. The development of anti-phospholipase A2 antibody response showed a prominent individual variability, as previously described.


Protective effect of a monoclonal antibody specific for an echovirus cellular receptor in human fibroblast and simian kidney cell lines.

We previously reported that infection of KB cells by echoviruses (EV) was inhibited by a KB-derived EV receptor murine monoclonal antibody (mAb 143). This antibody enabled the identification of a cellular receptor common to all echoviruses (with the exception of EV-22 and -23) and coxsackievirus (CV) A9, but different from the receptor of other picornaviruses. We now present results of cell protection assays conducted with human and simian cell lines different from the KB cell line used for production of mAb 143. When human embryonic lung fibroblasts were pretreated with 150 micrograms/ml of mAb 143, EV-11 and CV-A9 were completely inhibited (more than a 2-log difference compared to untreated cells). When the cell protection experiments were performed with Vero cells, the same results were observed with EV-33, but not with EV-22. The protection afforded human fibroblast cells by mAb 143 persisted for at least 5 days after 2-h exposure to 100 TCID50 of EV-11. These results suggest that EV receptors can be effectively blocked for prolonged periods in susceptible cells.


Role of acylation of viral haemagglutinin during the influenza virus infectious cycle.

We investigated fatty acid residues bound to the haemagglutinin (HA) of type A influenza viruses by growing the viruses in permissive chick embryo fibroblasts (CEF) and in non-permissive HeLa-229 cells using a maintenance medium containing 3H-palmitic acid. Our results suggest that fatty acid acylation of the major viral glycoprotein may be an important prerequisite for the production of mature viral particles. Indeed, palmitoylation is found in infected CEF, but is completely lacking in non-permissive HeLa-229 cells infected by the same virus strains. We conclude that this type of post-translational modification of virus HA glycoprotein could be a general phenomenon regulating the maturation and budding of influenza virus.


Rift Valley fever epizootic in the central highlands of Madagascar.

Between February and April 1991, unusual numbers of bovine abortion around Antananarivo (central highlands, Madagascar) were reported by official veterinary services. Rift Valley fever (RVF) virus isolations were made from sixteen aborted foetuses and one dead calf in different foci. Using monoclonal antibodies, the isolated viruses were found to be different from the 1979 RVF strains isolated in Madagascar from mosquitoes and human laboratory infection, and closer to African RVF strains. In a bovine population--previously characterized by a negative or very low RVF antibody prevalence--a high prevalence of IgM antibodies (264/994: 26.5% positive) was revealed; the IgM prevalence in recently aborting females varied from 40 to 91%. Among 994 human sera tested by IgG-IFA (immunofluorescent antibody assay) and IgM ELISA, 8.2% and 4.5%, respectively, proved positive. A total of 11,371 mosquitoes (61% Culex antennatus) were collected in the epizootic areas and tested without any virus isolation. Extensive studies were conducted to determine the geographical extension and the impact of this epidemic on the highly susceptible livestock and human populations.


Continuous cell lines and immune ascitic fluid pools in arbovirus detection.

Successive experiments led us to use two cellular systems, MOS61 (Aedes pseudoscutellaris cells) and Vero cells, among the continuous cell lines recommended by the WHO Collaborating Center for systematic research and isolation of arboviruses. Virus detection in cell cultures is carried out with 7 mixtures containing 10 hyperimmune ascitic fluids made with the reference viruses. This technique enables the detection of 70 of the 80 arboviruses transmitted by mosquitoes in Africa and very easily detects arbovirus associations by using either monospecific or monoclonal immune ascitic fluids (dengue-1-2-3-4 and yellow fever viruses) used in the indirect immunofluorescence technique.


Levels of IgM antibodies against dengue virus in Rio de Janeiro, Brazil.

The appearance and persistence of IgM antibodies were studied by MAC-ELISA in 926 confirmed cases of dengue virus type 1 infection. Assays performed on acute and convalescent patient sera revealed that IgM antibodies appeared during the early phase of disease (day 2) and persisted for three months after onset. MAC-ELISA proved to be a valuable early diagnosis test when compared with haemagglutination inhibition.


The cost of hospital stay for operable breast cancer.

The cost of the first hospital stay for operable breast cancer was deducted by analysing a random sample of 100 admissions to the National Institute of Cancer during the period January-December 1989. The aims of the study were: (1) to describe and calculate the cost component of the stay; (2) to analyse whether any procedure, service rendered or stage of the pathology might explain differences in the total costs of the stay; and (3) to acquire a better knowledge of the organizational aspects to be improved. With an average length of stay of 14.1 days, the overall total cost observed was 4.9 million lira (US $3.800, 1989 US dollars). A significant correlation between total cost and duration of stay was found (R2 = 0.982), while no or very little correlation was found between cost and the anatomical extent of disease (TNM stage) and different cost items (laboratory, imaging tests, operating room, etc.). Two homogeneous groups of cases were found: patients with quadrantectomy and patients with mastectomy. The cost of the latter was 40% greater than that of the former (P < 0.001) with a length of stay 52% longer (p < 0.001). This study does not concern the costs immediately following the stay, which namely are higher for the quadrantectomy because the radiotherapy outpatient procedures. Attention should be paid to reducing the length of stay, keeping waiting time for organizational procedures to a minimum during the stay.


Descriptive epidemiology of stomach cancer in Ragusa, Sicily, 1981-1988.

An epidemiologic study was carried out on 475 incident cases of gastric cancer registered by the Ragusa Cancer Registry (Sicily) between 1981 and 1988. Distribution by sex, age, subsite, year of incidence, and survival was investigated. A reduction of incidence and mortality between 1981-84 and 1985-88 was observed in both sexes, and was more evident in males than in females. Survival was not significantly different for cancers of the various subsites.


Morphogenesis of epithelial lesions in the lymphoid patches of Fischer 344 rats during cyclosporine-A-induced prolonged immunosuppression.

Alterations of intestinal lymphoid patches induced by cyclosporine A (CS-A) were studied in male Fischer 344 rats. Continuous treatment with CS-A (10 mg/kg b.w. by gavage daily) resulted in lymphocyte deficiency of the intestinal lymphoid patches followed by progressive replacement of the lymphoid tissue by cystic and glandular epithelial structures and single cells positive for epithelium-associated immunohistochemical markers. Cessation of CS-A administration led to regression of the alterations and a moderate recovery of the lymphoid patches. Morphologic changes induced at the epithelial-lymphoid border may be a useful parameter to estimate immunotoxicity.


Biologic relevance of elevated red cell adenosine deaminase activity in myelodysplastic syndromes and paroxysmal nocturnal hemoglobinuria.

Red cell adenosine deaminase (ADA-RBC) activity in patients with myelodysplastic syndromes and paroxysmal nocturnal hemoglobinuria is significantly increased compared to that observed in normal controls. ADA-RBC activity is not related to fetal hemoglobin concentration, but it is significantly correlated with hemoglobin concentration at diagnosis and with the degree of morphologic dysplasia in the erythroid lineage. The results of our study suggest that the observed enzymatic abnormality may constitute a non-specific manifestation of the stem cell alteration that determines these disorders.


Adjuvant radiotherapy of the pelvis with or without reduced glutathione: a randomized trial in patients operated on for endometrial cancer.

A randomized pilot trial was performed to evaluate the feasibility of administration of glutathione (GSH, 1200 mg, i.v.) as a protector in preventing diarrhea in patients operated on for endometrial cancer and submitted to adjuvant radiotherapy of the pelvis. Diarrhea occurred in 52% of patients in the untreated control group and only in 28% of patients in the GSH-treated group. Our preliminary data indicate that GSH administered before radiotherapy reduced the occurrence of diarrhea from oxidative damage to the intestinal mucosa. A large-scale phase III study is required to obtain definitive conclusions on the protective potential of GSH.


Mitomycin C and vindesine: an ineffective combination chemotherapy in the treatment of malignant pleural mesothelioma.

Twelve patients with malignant pleural mesothelioma were subjected to mitomycin C (MMC) and vindesine (VDS) chemotherapy (MMC 10 mg/m2, i.v., d 1; VDS, 3 mg/m2, i.v., d 1-8, every 4 weeks). No objective response was obtained; 3 (25%) patients had stable disease and 9 (75%) progression of disease. We conclude that MMC plus VDS is an ineffective combination chemotherapy in the treatment of malignant pleural mesothelioma.


Neuroimmunotherapy with subcutaneous low-dose interleukin-2 and the pineal hormone melatonin as a second-line treatment in metastatic colorectal carcinoma.

On the basis of our previous preliminary data which showed that the pineal hormone melatonin (MLT) may potentiate IL-2 activity and reduce the dose of IL-2 required to determine an effective host antitumor response, we performed a clinical study with low-dose IL-2 given once/day subcutaneously (3 million IU/day for 6 days/week for 4 weeks) in association with MLT (50 mg/day orally at 8.00 p.m. every day) as a second-line therapy in metastatic colorectal cancer patients pretreated with 5-fluorouracil. Evaluable patients were 13/14, and most of them showed disseminated liver metastases. No objective tumor regression was seen. A stabilization of disease was achieved in 4/13 patients (median duration 5+ months), and the other 9 patients progressed. Mean number of lymphocytes and eosinophils significantly increased during the treatment. Moreover, the mean increase in lymphocyte number was significantly higher in patients with stable disease than in those with progressive disease, whereas there was no difference as regards eosinophils. Serum levels of neopterin and tumor necrosis factor (TNF) significantly increased during therapy, and TNF increase was correlated to the side effects rather than to the control of cancer development. This study shows that neuroimmunotherapy with low-dose interleukin-2 and MLT, even though capable of determining an evident expansion of immune cells involved in host antitumor response, does not seem to be effective in terms of tumor regression in metastatic colon cancer patients pretreated with 5-fluorouracil.


Surgical and adjuvant radiation therapy of resectable retroperitoneal soft tissue sarcomas in adults.

Primary soft tissue sarcoma of the retroperitoneum is a rare disease. A series of 11 evaluable adult patients with retroperitoneal soft tissue sarcomas is reported. These patients were treated with complete surgery and adjuvant radiation therapy (total dose from 50 to 64 Gy) using an 18 MeV linear accelerator. After a median follow-up of 48 months (range, 6-84), 4 patients had a local-regional recurrence, 3 had distant metastases, and 4 died of progressive disease. Four-year estimated disease-free survival was 54.5% and overall survival was 70%. Treatment was well tolerated by most patients: 7 patients experienced moderate gastrointestinal toxicity, mainly nausea and diarrhea, during radiotherapy; 2 cases had weight loss > 15% at the end of the therapy; and chronic ileitis was observed in 2 cases. We conclude that adjuvant radiotherapy seems to reduce the incidence of local-regional recurrences in these patients. No radiation-induced irreversible injury was observed, but one young woman had amenorrhea after radiotherapy. Controlled clinical trials are warranted to define the role and effectiveness of adjuvant radiotherapy and/or chemotherapy in retroperitoneal soft tissue sarcomas.


Single brain metastases from kidney tumors. Clinico-pathologic considerations on a series of 29 cases.

Twenty-nine cases of single cerebral metastases from renal carcinoma were the object of a retrospective and prospective study covering a period of 15 years (1975-1988). The best diagnostic means were NMR imaging with paramagnetic contrast medium and CAT scans after intravenous injection of a double dose of contrast medium. All patients underwent total surgical removal of the cerebral lesion. Radiotherapy was useful but had less influence on further reproduction than in metastases from tumors of other sites. The median survival was 28.1 months in patients who received radiotherapy and 23 months in the others. No significant difference in survival was found between the group of patients with unknown primary tumors and the other group with diagnosed primary neoplastic disease.


Adjuvant therapy for primary breast cancer in a female patient affected by autoimmune liver disease: does it cure breast cancer and primary biliary cirrhosis?

Polychemotherapy (CMF or CMF-like regimens) is the treatment of choice in premenopausal breast cancer patients with 1-3 positive nodes. In clinical practice, patients with abnormal biochemical tests of liver function are usually excluded from this potentially curative methotrexate-containing regimen in order to avoid worsening of hepatic damage. On the other hand, recent reports have shown a beneficial effect of methotrexate in a particular autoimmune liver disease such as primary biliary cirrhosis. We discuss the case of a female patient with breast cancer and primary biliary cirrhosis whose biochemical tests of liver function and the titer of antimitochondrial antibody persistently improved after treatment with 3 cycles of CMF. In conclusion, we suggest that the CMF regimen is potentially useful in patients with breast cancer and primary biliary cirrhosis.


Primary spinal epidural non-Hodgkin's lymphoma. The contribution of nuclear magnetic resonance imaging, therapeutic approach and review of the literature.

Primary spinal epidural lymphoma (Stage I) is diagnosed predominantly late after a long prodromal phase of local back pain resulting in spinal cord compression. The use of CT and NMR images in the early stage of investigation and their analysis may help to diagnose these cases prior to the appearance of neurologic deficit. We report on 2 patients who presented with prolonged localized back pain with sudden symptoms of spinal cord compression. CAT scan and NMR imaging demonstrated the characteristic appearance of lymphoma. Decompressive laminectomy supported the diagnosis. Radiotherapy treatment to the region of the non-Hodgkin's lymphoma resulted in complete resolution. Thereafter, systemic chemotherapy with CHOP achieved a good response.


Kaposi's sarcoma on a lymphedematous arm following radical mastectomy.

Chronic lymphedema predisposes for local immune incompetence, manifested by development of Stuart-Treves syndrome, Kaposi's sarcoma and fibroma-like lesions. A 91-year-old female with multiple cancers developed classic Kaposi's sarcoma on a chronically lymphedematous arm 26 years after radical mastectomy and irradiation of the involved axilla. The Kaposi lesion partially responded to electron beam irradiation.


Bladder leiomyoma in pregnancy: a case report.

We herein report a rare case of an asymptomatic bladder mass seen during pregnancy in a young woman. A hypogastric mass was detected at antenatal checkup in the 7th month of pregnancy. The mass increased in size as the pregnancy went to term. Three months after normal delivery, she underwent surgery and a tumor arising from the bladder wall was excised completely. Histology showed a symplastic leiomyoma.


Adrenal gland metastasis in osteogenic osteosarcoma. A radiological case report.

Adrenal gland metastases from osteogenic sarcoma are rare and an unusual pattern of relapse. The recognition of solitary metastases, particularly when located in uncommon sites is very important for subsequent treatment. The authors describe the radiological features of an adrenal metastases from osteogenic sarcoma.


[Biologic quality of colostrum and calves from dairy cows injected with zinc during pregnancy].

The effects of an administration of the Zindep inj. preparation (Biotika) were evaluated in pregnant dairy cows as exerted on specific weight, total protein (TP) content, total immunoglobulin (IgC) and albumin (ALB) contents in colostrum. These parameters were also followed: calf's health, live weight, leucocyte (Lc) counts, T-lymphocyte (T-Ly) counts, contents of TPs, IgCs and ALBs in the blood serum of calves. Zinc concentrations were determined in colostrum, milk and calf blood serum. Our observations included 16 dairy cows in the seventh month of pregnancy in the second lactation and their calves in the winter feeding season. Eight experimental dairy cows were treated with the Zindep preparation in form of an injection to the neck muscles at a dose of 3 mg Zn/kg live weight in the mid-seventh month of pregnancy. Blood samples were taken from v. jugularis from all calves before their first drinking, on days 5, 15 and 30 of age. Colostrum, and/or milk samples were obtained by drawing of the colostrum or milk from the udder quarters within 60 minutes after parturition, on days 5 and 15 of lactation. Zn levels at birth were 16.48 +/- 2.67 mumol/l in experimental calves and 13.84 +/- 3.19 mumol/l in control calves. Zincaemia decreased slightly in both groups on days 5 and 15 of age, but it was insignificantly higher in calves coming from Zindep-treated dairy cows. Zn levels in the blood serum on the 30th day of age were 18.45 +/- 2.44 mumol/l in experimental animals and 15.73 +/- 3.11 mumol/l in control animals. Zn content in the colostrum of experimental cows was 2.40 +/- 0.42 mg/l and in the control it was 1088 +/- 0.52 mg/l (P < 0.05). On day 5 of lactation, Zn amounts in the milk of experimental dairy cows decreased to 0.95 +/- 0.12 mg/l and to 0.76 +/- 0.10 mg/l in the control (P < 0.01). Zn levels in the milk of experimental cows on day 15 of lactation were 0.95 +/- 0.13 mg/l and in the milk of control group they were 0.82 +/- 0.14 mg/l. Colostrum specific weight from zinc-treated cows was 1,067.86 +/- 0.75 g/cm3 and 1,056.8 +/- 13.53 g/cm3 in the control. TP and IgC concentrations were 137.81 +/- 38.11 g/l and 110.13 +/- 29.91 U ZST, respectively, in the colostrum of experimental group, and 105.98 +/- 32.02 g/l and 85.53 +/- 25.42 U ZST, resp., in control animals.(ABSTRACT TRUNCATED AT 400 WORDS)


[Body weight and selected hematologic and biochemical parameters in calves fed various diets during milk feeding].

The objective of the present paper was to obtain haematological and biochemical parameters of calves during their milk feeding. Another goal was to compare a current feed ration containing the commercial feed mixture Biosan with two alternative rations comprising skimmed milk and fat supplement. The effect of milk drink acidification and the effect of the physical form of fat added to skimmed milk were investigated. the calves were divided into six groups, by 6 to 8 calves each (P1-Biosan, PP1-acid variant, P2-skimmed milk+fat concentrate powder KMKS, PP2-acid variant, P3-skimmed milk+fat paste, PP3-acid variant). The highest average daily liveweight gains were recorded in calves fed on unacidified skimmed milk with fat paste supplement (1.074 kg)-Tab. I. The highest average daily liveweight gains were observed in calves fed on fat paste enriched milk drink (P3) while the calves administered milk with fat concentrate powder (P2) had only slightly higher average daily weight gains than the calves on Biosan diet (group P1). The growth of daily weight gains as a result of diets containing acidified milk (PP1 and PP2) is also a positive finding; this growth is even statistically significant in the former case (P < 0.05). The calves showed hypohaemoglobinaemia from the beginning of the experiment (51.3-69.0 g/l) and the low haematocrit value (0.29-0.43 l/l), Tab. II, while the plasma iron level was paradoxically high (Tab. V).(ABSTRACT TRUNCATED AT 250 WORDS)


[The effect of culture media on bacteriocin production in various strains of bacteria].

Some staphylococcus and enterococcus strains were used to investigate the effect of culture medium on bacteriocin production. Staphylococcus cohnii SC7, Staphylococcus sp. ZTJ 151, S. saprophyticus SS 877, Enterococcus faecium EF1 and E. faecalis EFG2 were isolated from the rumen wall and contents of lambs, calves and fallow deer, Enterococcus gallinarum EG10 and E. avium EA12 were isolated from the caecum of Japanese quail. The tested bacteria belong to producers with a wide antimicrobial effectiveness spectrum, they have low to medium adherence and urease activity (Tab. III). These culture media were used to test the effect of culture medium on bacteriocin production: nutrient agar no. 2 and VL agar enriched with 2% of glucose and lactose (ZAG, ZAL, VLG, VLL), agar for isolation of faecal streptococci (SA) and the base for blood agar no. 4 and no. 2 (KA4, KA2). The strains Streptococcus bovis AO 24/85 and Staphylococcus aureus Oxford 209 P were used as indicator bacteria. Tables I and II show the results of these tests. The tested strains produced the widest inhibition zones (6 mm) with both indicators on SA medium, and this indicates massive bacteriocin production. On ZAG medium, the zones of enterococci with the AO 24/85 strain were larger size than those of staphylococci, but the zones were dim. All strains with the 209P indicator produced dim zones of the 2mm size. The larger inhibition zones (2-5mm) in comparison with staphylococci were observed in enterococci on the ZAL medium with the AO24/85 strain. The production of tested strains was balanced on VLG agar with respect to the use of both indicators.(ABSTRACT TRUNCATED AT 250 WORDS)


[Inhibitory effects of organic acids and salts on selected micromycetes].

Inhibitory effects of two fungistatic preparations (A and B) and of propionic acid were tested in a complete feed mixture for broiler chickens (starter mixture). The water content of this mixture was 25.4%, environmental temperature was 24 degrees C and relative air humidity 90%. Propionic acid, which has a high fungistatic effect, served as a standard. The composition of the preparation A was as follows: propionic acid, acetic acid, sorbic acid, citric acid and calcium propionate. The preparation B contained: sorbic acid, citric acid and calcium propionate. Examinations were performed in a naturally contaminated and subsequently sterilized (25 kGy) feed mixture; it was then infected with Aspergillus fumigatus, A. niger, A. parasiticus and Penicillium purpurogenum from the Collection of Animal Pathogenic Microorganisms, Brno. A. flavus, A. fumigatus, A. glaucus, Penicillium sp., Absidia corymbifera, Mucor sp., Rhizomucor pusillus were detected in the naturally contaminated feed mixture. The mycoflora which was found in the native substrate was resistant to both tested fungistatic preparations; and this resulted in mycelium growth from 7th day of incubation. The efficiency of the preparations A,B and of propionic acid in the feed mixture was identical at concentrations of 4 mg/kg, 7 mg/kg and 3 mg/kg, respectively, and their inhibitory effects were lowest at these concentrations (Fig. 2). A high water content in the nutrient substrate resulted in the rapid growth of fungi of the Mucorales species. The relative humidity of the environment (90%) and water content of tested samples affected markedly micromycetes growth in this experiment.(ABSTRACT TRUNCATED AT 250 WORDS)


[The effect of fungal and yeast glucan and levamisole on the level of the cellular immune response in vivo and leukocyte phagocytic activity in mice].

The level of cell-mediated immune response in vivo was investigated using the test of delayed hypersensitive reaction (DHR) to DNFB, along with the phagocytic activity (PA) of blood leucocytes in mice after subcutaneous implantation of fungal and yeast glucan and levamisol in dependence on the dose and administration schedule. The soluble form of fungal glucan (Pleurotus ostreatus) potentiated the DHR significantly at a dose of 10 mg/kg (but not at a dose of 50 mg/kg) while it was administered during DNFB sensitization (P < 0.05)-Tab. I and when its pre-medication effect was investigated (days -7 and -14; P < 0.05) with regard to the time of sensitization (Tab. II). The identical dose of glucan also had a positive effect (P < 0.05 or 0.01) on the percentual proportion of phagocytic cells (PC) reaching the maximum in the 2nd and 3rd week of investigation, as well as on the phagocytic activity index (P < 0.05; 3rd week) and percentage of neutrophil granulocytes (P < 0.05; 2nd week)-Tab. III. Yeast glucan (Saccharomyces cerevisiae) showed a potentiating effect on the DHR to DNFB only in the case of its pre-medication use; its soluble form was effective at both doses (10 mg and 50 mg/kg) in days -7 and -14 (P < 0.05), and its corpuscular form at a dose of 50 mg/kg on days -7, -14 and -21 (P < 0.05 or 0.01)-Tab. II. PA parameters of blood leucocytes displayed a stimulative effect only on the PC percentage. The most significant effects in this case were observed in the soluble form (both doses) in the 2nd and 3rd week (P < 0.01 and 0.05, resp.) and in the insoluble form (both doses) in the 3rd and 4th week of observation (P < 0.05 and 0.01, resp.). An increase in the number of neutrophil granulocytes was significant in the 2nd (P < 0.05 or 0.01; corpuscular form) and 3rd week of the experiment (P < 0.01; soluble form)-Tab. III. Levamisol affected both investigated parameters (DHR and PA) only at a dose 20 mg/kg (10 mg/kg-no effect). Its potentiating effect on the DHR level was observed both for its administration at the time of sensitization (P < 0.05) and for its administration on days 7 (P < 0.05) and 14 (P < 0.01) before DNFB sensitization (Tabs. I and II). A statistically significant increase in PC was recorded in weeks 2, 3 and 4 (P < 0.05 or 0.01), a statistically significant increase in the number of neutrophil granulocytes in the 3rd week of investigation (P < 0.05). The phagocytic activity index was not affected.


[A computer program for toxico-chemical analysis using gas chromatography].

A high probability of identification of substances containing nitrogen or phosphorus in their molecules is obtained by the original gas chromatographic (GC) system. It enables the reliability of positive identification in 98.43% of cases compared with the modern GC where for the chromatographic library spectrum of 200 substances the probability of identification of unknown substances is only 28.13%. GC system is based on the parallel configuration of the two capillary columns of different polarities connected to the one-column injector and the one nitrogen-phosphorus detector as well as the original computer program developed on the qualitative-logistic approach to interpretation of chromatographic parameters using only one reference substance. The computer program can perform positive logistic identification also in the case when the unknown substance is in the closest chromatographic vicinity, with quite different reference substances on both capillary columns.


[Back ache in helicopter pilots].

Due to low back pain (LBP) and harmful effects of flying, questionnaires were sent to 71 helicopter pilots of the experimental group, 22 mechanics helicopter flyers and to the control group of 28 air-traffic controllers. The prevalence of LBP was the highest in helicopter pilots, then in helicomechanics and air-traffic controllers (53%, 50% and 36%). Effects of exposure to vibration, body posture and working load have not contributed significantly to the occurrence of LBP. LBP has not lead to an important difference in the strength of the back musculature, body mass index and spondylosis, that is, scoliosis. The necessity of further study of LBP and maintaining of specific preventive measures are indicated.


[Ultrasound, computer tomography and angiography in the diagnosis of dissecting aortic aneurysm].

The findings obtained by ultrasound, CT and angiographic examinations of 75 patients with dissecting aortic aneurysms operated on at the M.M.A. are analysed. The aim of each particular method was to detect the presence of dissection, the aortic entrance tear and type of dissection. These findings were compared with the operative findings. On the basis of the analysis it has been concluded that the precision of the diagnosis obtained by angiography was 93%, by CT 74% and by ultrasound 69%.


[Domiciliary rehabilitation of hemiplegics].

Within six years 71 patients with hemiplegia were rehabilitated under home care. The patients were tested before and six months after the completion of rehabilitation. After rehabilitation 16 of 50 patients remained at the level of care while 34 moved to higher categories. Of 71 patients 13 was capable for all activities of daily living.


[Decortication of the lung in the treatment of nonspecific pleural empyema].

In the period 1986-1990 at the Clinic of Cardiac and Thoracic Surgery 86 patients with nonspecific pleural empyema were treated. There were 18 men and one woman, mean age of 35.6 years. Causes of empyema have been the following: pleuropneumonia (10 patients), chest trauma (2), iatrogenic pleural infection (2), spontaneous pneumothorax (2), mediastinitis (1) and pleural infection per continuitatem (2). The authors consider that decortication should be performed as early as possible, immediately after stabilization of acute signs of infection. The optimal time for surgery is from to six hours since the onset of the disease.


[Alveolitis in patients with sarcoidosis].

In 20 patients with pulmonary sarcoidosis bronchoalveolar lavage (BAL) was performed. The cellular content was analysed and lymphocyte subpopulation was determined using monoclonal antibodies. The patients with more than 28% of BAL T lymphocytes are classified as patients with high intensity alveolitis (n = 8) and those with less than 28% of T lymphocytes as low intensity alveolitis (n = 12). Of the total number of BAL T lymphocytes in high intensity alveolitis CD 3+ T cells were 88.8 +/- 8.4% and in low intensity alveolitis 68.2 +/- 13.8% (p < 0.001). In high intensity alveolitis the number of CD 4+ T cells was increased and the number of CD 8+ T cells was decreased which caused the increased index CD 4:CD 8; 9.8 +/- 8.7. In low intensity alveolitis this ratio was 2.2 +/- 1.2. Effects of smoking were also analysed. In smokers the total number of BAL cells was higher 184.0 +/- 47.2 x 10(4) ml of BAL, and in nonsmokers 101.3 +/- 65.1 x 10(4) ml of BAL (p < 0.001). Smoking has no effects on the characteristics of the cellular elements and subpopulation of BAL lymphocytes in patients with sarcoidosis. In 7 patients T lymphocyte subpopulation in the peripheral blood were determined too. Patients with high intensity alveolitis had the increased index CD 4:CD 8 in the peripheral blood compared with low intensity alveolitis.


[Preparation of tormentila tincture using ultrasound].

The procedures of preparation of ultrasound tannin extraction for preparation of Tormentillae rhizome tincture are described and the comparison was made with maceration and biomaceration methods. The contents of the isolated tannin determined volumetrically was the same, but the time of ultrasound extraction is significantly shorter and also the procedure can be performed under field conditions.


[Magnetic stimulation of the motor cortex in healthy persons].

In 49 healthy volunteers the motor cortex was stimulated transcranially by the intensive short magnetic field and the responses of the m. abductor digiti minimi (m. ADM) in 20 volunteers were recorded and of the m. tibialis anterior (m. TA) in 29 volunteers in relaxation and in mild contraction. In all volunteers by the electric stimulation of the ulnar nerve in the region of the wrist and the peroneal nerve in the region of the fibular capitulum there have been measured the F wave latency, distal latency of M responses and the conduction time of the peripheral motor neuron has been calculated. The difference between the latency of m. ADM and n. TA responses and the conduction time of the peripheral motor nerve represented the central motor conduction time from the motor cortex to the motor neurons of the anterior horns of the spinal cord (C8 and L4 segments). The normative values of the absolute latencies of the muscle responses and the central motor conduction time in the relaxed and contracted muscle are calculated as well as the normatives of the normal differences in latencies and the central motor conduction time between the left and right side of the same subject.


[Effects of sodium valproate in a model of penicillin epilepsy in rats].

Effects of sodium valproate in penicillin-induced epilepsy in rats have been described. To one group of rats penicillin was given I.P. (10(6) IU/kg) and to the another one it was given I.C. (100 IU). After development of grand mal sodium valproate was given I.P. to all rats except the control group. In the group receiving I.C. penicillin it has come to cessation of individual discharges and grand mal after valproate application. In the group receiving I.P. penicillin, valproate prevented only grand mal while individual discharges remained. It is obvious that much higher doses of penicillin are necessary for the development of the epileptic model if penicillin is given I.P.


Narrowing the zone of uncertainty between research and development in biological warfare defense.

Although "research" is not prohibited by the Biological Weapons Convention, States Parties to the Convention have maintained the spirit of the Convention in actions relating to research. The confidence-building measures agreed to at RC2 refer to research facilities, publication of research results, and promotion of contacts between scientists engaged in research related to the Convention. However, assessment of basic research on biological agents is not a productive way to distinguish an offensive from a defensive program. Additionally, if a country were to initiate a biological weapons program, basic research on biological agents may not be necessary. For example, the extensive published research on Bacillus anthracis, both as a cause of anthrax in cattle and other species and as a biological-warfare agent, would enable any motivated group or nation to initiate a biological weapons program that could immediately advance to the development and scale-up stages. Research on biological agents for offensive purposes would be characterized by activities such as selection for growth, virulence, and toxin production; improving stability under varying environmental conditions; and selection of strains that might overcome existing means of prophylaxis and treatment. A biological program with an offensive intent would in most cases be characterized by evidence of development efforts in mass production and dissemination, which are often agent-specific. Thus, an assessment of development may distinguish offensive from defensive programs. If a country were to initiate a biological weapons research program, and were willing to risk worldwide condemnation should existence of such a program become known, it is likely that such a program would include development and production capabilities. If a country were not committed to production capability, there would be no rationale for an offensive biological research that would bring worldwide condemnation. Critics of the U.S. Biological Defense Research Program have suggested that the program could easily and quickly be turned into an offensive effort. To accomplish this, however, we have to assume that all military personnel, including the civilians employed by the Department of the Army, are unethical and willing to break the law and run the risk of placing the U.S. in a noncompliance status. The Army is under constant scrutiny by governmental agencies, by visiting scientists, by audiences at scientific meetings, by scientists who review manuscripts for publications, by news media, and by private citizens.(ABSTRACT TRUNCATED AT 400 WORDS)


[Feasibility, indications and immediate results of direct angioplasty without thrombolysis during the acute period of myocardial infarction].

Between June 1988 and November 1991, 64 out of 200 consecutive admissions (32%) before the 6th hour of myocardial infarction underwent angioplasty of first intention. Fifty men and 14 women (average age 62 +/- 11 years) benefitted from this 24 hour emergency interventional cardiology service. The indication was formal in 22% of patients because of a contra-indication to thrombolysis (N = 40) or cardiogenic shock (N = 4); in 6%, the choice was logical because of diagnostic uncertainty (N = 12); it was a deliberate choice in 4% of cases (N = 8). Successful angioplasty was defined as reperfusion of the occluded artery without circulatory delay or > 50% residual stenosis. Arterial recanalisation was attempted in all patients (associated with intraaortic balloon pumping in 3 cases) and was successful in 59 patients (92%) within 231 +/- 100 minutes of the onset of chest pain and within 49 +/- 29 minutes of hospital admission. The outcome was uncomplicated without any other intervention in 81% of patients (48/59). Three reocclusions were observed, two of which were symptomatic and treated successfully by repeat emergency angioplasty. Six surgical revascularisations were necessary (2 emergency, 4 secondary). One major complication related to the angioplasty was observed (haemopericardium). Global hospital mortality was 9% (6/64): three of the 4 patients admitted in cardiogenic shock, 3 of the 40 high risk patients with contra-indications to thrombolytic therapy, none of the 20 patients considered to be at low risk (uncertain diagnosis and deliberate choice).(ABSTRACT TRUNCATED AT 250 WORDS)


[Doppler echographic evaluation of mitral valve stenosis with atrial fibrillation. Construction of a nomogram].

Doppler echocardiographic evaluation of mitral stenosis is often difficult in patients with atrial fibrillation. Sixteen patients were examined by transthoracic Doppler echocardiography and the relation between the variations in transmitral end diastolic pressure gradient and the length of the corresponding cardiac cycles was analysed. Mitral valve surface area (1.65 +/- 0.73 cm2) was determined by the pressure half-time method. The end diastolic transmitral pressure gradient was calculated from the simplified Bernouilli formula applied to end diastolic mitral flow velocity. In each patient, a linear relationship was observed between the end diastolic mitral gradient and the corresponding RR interval. The slope and intercept of the graph correlated significantly to mitral valve surface area (r = 0.72, p < 0.002 and r = 0.93, p < 0.00001, respectively). Using regression equations describing these correlations, it has been possible to construct a nomogramme indicating mitral valve surface area as a function of mitral end diastolic pressure gradient and the duration of the corresponding RR cycle. This nomogramme facilitates Doppler evaluation of mitral stenosis in atrial fibrillation.


[Long-term prognosis of congenital atrioventricular block].

The aim of this study was to assess the long term prognosis of congenital atrioventricular block (AVB). From 1965 to 1990, 42 cases of congenital AVB (22 antenatal or natal diagnoses and 20 presumed congenital AVB according to Yater's criteria). The AVB was isolated in 28 cases and associated with cardiac disease in 14 cases (8 of which were corrected transposition of the great arteries). The average age of the patients was 14 years (range 32 years to 18 months) at the time of the study. There was a clear female predominance (64%). Maternal connective tissue disease was present in 18% of cases (in the group of children born after 1977 when maternal connective tissue diseases was systematically looked for). Cardiac failure was present in 10 cases (8 with associated AVB); syncope and sudden death were observed in 11 cases. The indication for pacemaker therapy was the presence of poor prognostic factors: syncope, poorly controlled cardiac failure, low heart rate, increased QRS duration, prolonged QTc, infrahisian AVB, long pauses or arrhythmias on Holter monitoring. The only significant prognostic factors in this series were a previous history of syncope, increased QRS duration and a QTc of over 0.45 seconds. Fourteen patients were paced (endocavitary pacing only from 1981), usually in the DDD mode: 8 for syncope, 2 for cardiac failure, 4 for a poor prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS)


[Clinical and hemodynamic prognosis after tricuspid valve replacement with bioprosthesis].

Between 1974 and 1990, 58 patients underwent tricuspid valve replacement with a porcine bioprosthesis (Hancock 42, Carpentier-Edwards 16) in the course of polyvalvular replacement (double 21, triple 37). Early postoperative mortality was 12%: 16 patients died secondarily, usually of cardiac causes. The actuarial survival (1 patient lost to follow-up) was 81 +/- 11% at 5 years and 60 +/- 17% at 10 years. Two patients were reoperated for dysfunction of a Hancock bioprosthesis, 11 and 15 years after implantation. At long-term, with an average follow-up of 108 +/- 48 months, 82% of survivors (28/34) were clinically improved. Doppler echocardiography was performed in 29 patients in February 1991. In 21 cases, with a follow-up of 88 +/- 40 months, the bioprosthesis was normal with an average diastolic transprosthetic pressure gradient of 3.8 +/- 1.7 mmHg. In 7 patients followed up for 129 +/- 40 months (p < 0.05) moderate dysfunction of the Hancock prosthesis was observed with a mean diastolic pressure. Severe dysfunction of a Hancock prosthesis was observed in 1 case. Fixed pulmonary hypertension was noted in 11 cases and was associated with a poor clinical result and a raised mean diastolic transprosthetic pressure gradient. The durability and haemodynamic performance of tricuspid porcine bioprostheses are satisfactory in the long term. Prosthetic dysfunction is correlated to the duration of implantation of the bioprosthesis and to persistent pulmonary hypertension.


[P wave changes and atrial fibrillation after implantation of VVI type pacemaker].

The P waves of patients with VVI pacemakers were compared with those of DDD pacemakers at implantation and then regularly for 5 years. A certain number of cardiac pathologies are known to cause P wave changes. The incidence of atrial fibrillation (AF) was much higher in VVI than in DDD patients. In the VVI group, the incidence was much greater in patients paced for sinus node disease than in patients paced for AVB. Analysis of sinus P wave characteristics in 320 patients with VVI pacemakers shows progressive abnormalities of atrial function with time. The expression of this atrial dysfunction is a statistically significant prolongation of the P wave in V1 and dII and of the terminal part of the P wave in V1. The factors responsible for this abnormality and which favours the occurrence of AF are quasi-permanent pacing, the presence of retrograde conduction and an abnormality of atrial activation at the time of implantation.


[Left ventricular dilatation after primary transmural anterior myocardial infarction. Influence of the percentage of akinesia on echocardiography].

The aim of this study was to determine whether the percentage of akinesia on echocardiography during the acute phase of transmural anterior myocardial infarction could predict secondary left ventricular dilatation. The study group comprised 24 patients (18 men and 6 women) with an average age of 59 years. The patients underwent two echocardiographic examinations, the first during the acute (< 72 hours) phase and the second, 6 months later. Ventricular volumes were calculated by the ellipse monoplane method in the apical 4 chamber view. The percentage of akinesia was defined as the ratio between the length of the akinetic segment and the left ventricular end diastolic perimeter in the apical 4 chamber view. An increase in end diastolic volume (83 +/- 25 vs 62 +/- 18 ml/m2; p < 0.01) and in end systolic volume (51 +/- 27 vs 34 +/- 11 ml/m2; p < 0.01) was observed 6 months after infarction without a significant change in ejection fractions (42 +/- 17% vs 44 +/- 10%). The percentage of akinesia in the acute phase was > 30% in 15 patients (Group I) and < 30% in 9 patients (Group II). The increase in ventricular volumes at 6 months after infarction was significant in Group I (p < 0.02) but not in Group II. At 6 months after infarction, the end systolic volumes were greater (60 +/- 27 vs 37 +/- 22 ml/m2, p < 0.5) and the ejection fractions were lower (35 +/- 13% vs 53 +/- 18%, p < 0.01) in Group I than in Group II.(ABSTRACT TRUNCATED AT 250 WORDS)


[Efficacy and tolerance of 2 new percutaneous vena cava filters. A prospective study in 80 patients].

Eighty consecutive patients with an average age of 66.5 +/- 16 years were reviewed 3 and 9 months after implantation of two new percutaneous vena caval filters (Filcard, Cardial) in order to evaluate their efficacy and tolerance. The indications were: a contra-indication to anticoagulants in 19 cases, recurrent pulmonary embolism under anticoagulant therapy in 22 patients, chronic cor pulmonale in 4 patients; finally, in 35 cases, the filter was implanted prophylactically for a "floating" or extensive ilio-caval thrombosis under anticoagulant therapy or in high risk patients: severe cardio-pulmonary failure, malignant disease, massive pulmonary embolism with a contra-indication to fibrinolytic therapy. All implantations were performed by the jugular approach with no local or general complications apart from one pericaval haematoma with a favourable outcome. Cavography and opacification of the renal veins was carried out systematically during implantation. All patients underwent clinical examination, antero-posterior and lateral X rays of the filter, pulmonary scintigraphy, antero-posterior and lateral cavography, a CT scan of the filter, Doppler ultrasonography and rheoplethysmography of the legs 3 months after implantation. At 9 months, clinical examination, abdominal X rays and rheoplethysmography were repeated. There was 100% follow-up at 3 and 9 months. The complications observed at 3 and 9 months were: 5 cases of malposition (6%), 3 recurrent pulmonary emboli (4%), 9 recurrent venous thromboses (13%), 4 vena caval thromboses (5.7%), 7 thrombi caught in the filter (10%), 27 perforations of the vena cava (38%), 3 over 30 degrees tilts of the filter (4%) and 22 migrations (31%).(ABSTRACT TRUNCATED AT 250 WORDS)


[Influence of exercise on the permeability of accessory pathways and supraventricular arrhythmia in Wolff-Parkinson-White syndrome].

The influence of adrenergic stimulation on the effective anterograde refractory period of the accessory pathways and on supraventricular arrhythmias, was studied in 20 patients (average age 38 +/- 16 years) with an untreated permanent Wolff-Parkinson-White syndrome and a resting anterograde refractory period < or = 400ms. Repeated electrophysiological studies with a single endocavity catheter positioned near the atrial pole of the accessory pathway were performed under basal conditions and during a standardised exercise test on a bicycle ergometer. The effective anterograde refractory period of the accessory pathway, the length of the tachycardia cycle during reciprocating orthodromic tachycardia, the average heart rate, the percentage of preexcited QRS complexes during induced atrial fibrillation, were measured in all patients under basal conditions and at the peak of exercise. Exercise significantly reduced the anterograde refractory period of the accessory pathway (287 +/- 49 ms at rest versus 238 +/- 24 ms on exercise: p < 0.001), the cycle of orthodromic tachycardia (302 +/- 32 vs 260 +/- 22 ms p < 0.001), the minimal R-R interval (270 +/- 65 vs 227 +/- 46 ms: p < 0.05) and % of preexcited QRS complexes (75 +/- 33 vs 51 +/- 39: p < 0.05) in atrial fibrillation whilst increasing the average heart rate (165 +/- 42 vs 202 +/- 39 bpm: p < 0.02). Adrenergic stimulation significantly improves anterograde conduction in the accessory pathway. The reduction in the % of preexcited QRS complexes in atrial fibrillation could indicate a preferential action of catecholamines on the nodo-hisian pathway.(ABSTRACT TRUNCATED AT 250 WORDS)


[Results of coronary-angiographic evaluation after endocavitary fulguration of the accessory pathways].

Left ventricular aid coronary angiography was performed systematically in 32 consecutive patients (average age 34 +/- 16 years) to assess the potential risk of coronary and myocardial lesions after high energy catheter ablation of an accessory pathway. The control was performed 2 to 6 months after the procedure in 30 patients and as an emergency immediately after the procedure in 2 patients because of prolonged ST segment elevation in 1 and an echocardiographic abnormality in the other. The catheter ablation was performed by a right heart approach in 19 patients and by retrograde catheterisation of the left heart in the other 13. The average number of shocks delivered was 3.6 +/- 2.4 in 1.8 +/- 1.2 session with an average energy of 632 +/- 220 joules. The global success rate was 88%, 70% complete successes and 18% clinical successes. The left ventricular and coronary angiographies were normal in 31 patients, including the 2 patients investigated as an emergency. On the other hand, one totally asymptomatic patient in whom a left lateral bundle of Kent had been ablated 2 months previously by a retrograde transaortic approach, had a large pseudo-aneurysm of the left ventricular posterior wall and coronary angiography showed a fistula between the first lateral branch of the circumflex artery and the left ventricle. At surgery, a localised rupture of the mitral annulus was confirmed. Two factors may at least partially explain this complication: the quantity of energy delivered (1,000 joules) in a single session to a limited area, and the site of ablation on the ventricular side of the mitral annulus.(ABSTRACT TRUNCATED AT 250 WORDS)


[Interference between cardiac pacemaker and electromagnetic anti-theft devices in stores].

Electromagnetic anti-theft devices in shops comprise large diameter magnetic induction coils between which the shoppers pass. This study was undertaken with a simulator to assess the behaviour of different models of single and double-chamber pacemakers when exposed to 6 stereotyped and repetitive situations of 4 different electromagnetic anti-theft devices. Of the 35 pacemakers tested, 25 developed serious dysfunctions: 14 long-lasting inhibitions (over 3 seconds), 2 stimulations at maximal frequency, 2 electrical bradycardias and 2 permanent reprogramming. These dysfunctions due to electromagnetic interference are observed in old or modern, monopolar or bipolar pacemakers, and seem to be influenced by the amplitude and complexity of the signals emitted by the detectors. These observations justify a clear signalization warning pacemaker patients of a potential danger.


[Comparison of prognosis and treatment of myocardial infarction in Haute-Garonne between 1986 and 1989. MONICA project, Toulouse].

The aim of this study, based on the data of the MONICA register in the Haute-Garonne, was to compare the prognosis and treatment of myocardial infarction between 1986 (253 cases) and 1989 (248 cases). The clinical features of these infarcts were comparable except for the previous history of ischaemic heart disease which was less common in 1989 (34.7% in 1986, 25.9% in 1989; p < 0.05). The 28th day mortality decreased from 8.4% in 1986 to 3.6% in 1989 without attaining statistical significance. The pre-hospital management was the same during the two periods of the study, with 67.6% of patients admitted to hospital before the 6th hour. Hospital care in 1986 and 1989 consisted of 5 days in the intensive care unit and lasted 14 days. Treatment changed considerably from 1986 to 1989. There was a higher incidence of platelet antiaggregant prescriptions (47.4% in 1986 and 80% in 1989; p < 0.001), of betablocker prescriptions (30.8% in 1986 and 47% in 1989; p < 0.05) and fibrinolytics (27.8% in 1986 and 52% in 1989; p < 0.01). Invasive procedures such as coronary angiography (83.5% in 1986 and 94% in 1989; p < 0.05), coronary angioplasty (20.3% in 1986 and 53.5% in 1989; p < 0.01) were undertaken in the majority of cases. The MONICA-Toulouse project shows a reduction in mortality and an increase in the use of therapeutic methods known to be effective in the reduction of mortality in myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)


[Intravenous thrombolysis by recombinant plasminogen activator (rt-PA) in unstable angina. A randomized multicenter study versus placebo].

Fifty patients (38 men) with unstable angina pectoris defined by: pain lasting > 15 minutes+percritical electrocardiographic changes+significant coronary narrowing on coronary angiography (Coro 1) performed within 24 hours, were treated in a double blind protocol with rt-PA (n = 25) 100 mg/90 minutes (10 mg bolus + 90 mg/90 minutes or placebo (n = 25). All received effective intravenous heparin and intravenous nitrates. Calcium antagonists and betablockers were prescribed in half the cases. Aspirin (100 mg orally per day) was prescribed after control coronary angiography (Coro 2) performed 24 +/- 6 hours after starting treatment. Qualitative and quantitative analysis (CAESAR system) was centralised. There were no differences in the angiographic findings between the two groups. Intracoronary thrombosis was observed in 43% (rt-PA) and 44% (placebo) in Coro 1 and in 17% and 28% in Coro 2. The incidence of myocardial revascularisation procedures was similar in the two groups: angioplasty: 12 (rt-PA) and 13 (placebo); coronary bypass surgery: 5 (rt-PA) and 6 (placebo). Seven patients developed myocardial infarction (5 rt-PA, 2 placebo), one of whom died of cardiogenic shock (placebo). Eighteen patients had haemorrhagic complications (14 rt-PA, 4 placebo; p < 0.002) mainly at the puncture sites (12/14, 3/4). Spontaneous haemorrhage occurred in 7/25 (28%) of patients on rt-PA (haematuria 3, gastrointestinal haemorrhage 2, haematuria + gastrointestinal haemorrhage 1, epistaxis 1) and in 1/25 patients on placebo (gastrointestinal haemorrhage) This study shows that intravenous thrombolysis with rt-PA in severe unstable angina pectoris doe not modify the clinical outcome or the angiographic lesions but exposes patients to a high risk of haemorrhagic complications.


[Diverticulum of the right atrium. A case report and review of the literature].

Congenital atrial diverticula are rare, especially those involving the right atrium. This condition was observed in a 52 year old man who presented with palpitations. The diagnosis was made by two-dimensional echocardiography and confirmed by CT scan, magnetic resonance imaging and angiography. In the absence of significant invalidity, no treatment was recommended. Only three other cases of this condition have been previously reported, all of which were referred for surgery for thrombotic complications, arrhythmias and cardiac failure. Anatomo-pathological analysis showed different appearances: fibrous tissue and lipomatous degeneration. In the absence of associated heart disease, these aneurysms are probably congenital.


[Mediastinal hemangiopericytoma. Apropos of a case].

The authors report a new case of hemangiopericytoma in an elderly man. An asymptomatic mediastinal mass was found on a routine chest film. C.T. guided fine-needle biopsy was diagnostic. These rare lesions are clinically and radiologically aspecific and require pathologic proof. The value of percutaneous biopsy before therapeutic decision is emphasized.


[Atrioventricular block at nodal and infrahissian level during atrial tachycardia. Apropos of a case].

The authors report the case of a patient with atrial tachycardia and surface electrocardiographic signs of left anterior hemiblock and complete right bundle branch block with 10/3 atrioventricular block. The regularity of the RR intervals which were an exact multiple of the atrial cycle suggested the absence of a Wenckebach phenomenon. The sequence of atrioventricular conduction cannot be explained by classical models of intranodal conduction. Endocavitary recordings confirmed this hypothesis. They showed block at 2 levels: supra- and infrahisian. The suprahisian block functioned in the 2/1 mode and the infrahisian block in the 5/3 mode without incremental conduction distal to the His potential before the apparition of block. A double zone of intrahisian block could explain the observed sequence of atrioventricular conduction. The absence of Wenckebach phenomenon on the surface ECG during tachycardia could be a sign of infrahisian block. The authors suggest that the association of this sequence of atrioventricular conduction with intraventricular conduction defects is a formal indication for electrophysiological studies.


Comparison of energy deposition and utilization of feedstuffs and rations between growing and adult pigs.

The effect of energy deposition and the utilization of feedstuffs and rations were compared between growing and adult pigs. The good agreement in the data leads to the conclusion, that the energy deposition effect of feedstuffs and rations in growing pigs can be estimated with an equation based on measurements in adult pigs. Exceptions are feedstuffs which are digested bacterially to a relatively high part in the large intestine, as e.g. sugar beet pulp, raw potatoes or similar feed.


[The energetic utilization of rations with steamed potatoes in growing swine].

The energetic utilization of rations with steamed potatoes (40 and 50% of DM of ration) was measured in 8 growing pigs, live weight 30-70 kg by means of respiration experimental techniques. The experiments were carried out using the difference method (3 periods feeding basal diet and 3 periods feeding basal diet plus potatoes). The digestibility of energy of the steamed potatoes amounted to 94%, that of organic substances 96% and that of crude protein 77%. The metabolizable energy amounted to 16.1 and the energy deposition to 12.0 MJ/kg DM of steamed potatoes, 74.5% utilization respectively. The results in growing pigs are very similar to the results in adult pigs.


Effect of feedborne fluorine intoxication on broiler chicks' performance, biochemistry, physiology and pathology.

Feeding broiler chicks on graded levels of fluorine (0, 25, 125, 625 and 3125 ppm F) from NaF for 4 weeks (4-7 weeks of age) resulted in various alterations which depended on the level of contamination. The main changes included poor growth and feed conversion, high mortality rate, disorders of bone formation, decreased relative weights of pituitary, adrenal, heart, liver, spleen, lungs, kidneys and gizzard and changes in intestinal dimensions. Also, the biochemical tests revealed other kinds of physiological disfunction mainly in the form of anaemia (low haematocrit, haemoglobin, total protein, albumin and globulin fractions), intoxication (increased methaemoglobin), nephrotic (raised phosphorus and magnesium) and hepatic (elevated lipoproteins and lowering enzymatic activity) disfunctions. The general observations and postmortem examination confirmed also the biochemical findings which revealed the harmful effect of feedborne-fluorine intoxication in broiler chicks.


The quality of meat of lambs fed with feeds containing lasalocid.

The aim of the research was to determine the quality of meat of lambs fed with feeds containing lasalocid. It was ascertained that lasalocid added in the quantity of 50 mg per animal and day to the feed during the whole period of fattening considerably increased the protein content in the longest back muscle in lambs. The addition of 50 mg lasalocid to the feed considerably lowered the fat content in the muscle. The muscle of lambs receiving 50 mg of lasalocid had the best water binding capacity and thus was most suitable for the production purposes. Lasalocid influenced significantly and advantageously the intensity of colour of the muscle.


[The significance of the mycotoxins desoxynivalenol, zearalenone and ochratoxin A for agricultural domestic animals].

Mycotoxins are metabolic products of mycotoxins which have various chemical structures and show various toxic effects. Deoxynivalenol (vomitoxin) is an important economic factor in pig production due to growth depression and suppression of the immune system. Previous studies have shown that the 1-ppm limit in the sole feed for pigs should not be exceeded. Studies of methods of detoxification have as yet not produced conclusive results. Zearalenone has an tolerable effect and may lead to fertility disturbances on the oestrogen production in pigs and can cause remarkable economic damage even in the ppb range. Recommendations of upper limits cannot be made on the basis of the available results. The kidney toxin ochratoxin A is of importance in pig and poultry breeding and--due to its accumulation in the tissue--represents a possible source of danger to man. Since a possible carcinogenic effect of the toxin cannot be excluded, its content in animal rations should be kept as low as possible. For ruminants mycotoxins as a whole do not represent a particular source of danger as these substances can be degraded or converted by rumen flora.


Digital photoplethysmography in the diagnosis of traumatic vasospastic disease.

By means of the photoplethysmographic method including the cold test, skin blood flow was recorded in the fingers of 42 chain-saw operators and 36 control subjects. The essential difference between the groups pertained to the height of the pulse wave amplitude after the cold test and to the fall in amplitude expressed as a percentage of its initial value. A limit of a 90% fall in amplitude after the cold test is proposed as a criterion for differentiating a normal from a pathological vasospastic reaction. A fall in amplitude is correlated with the intensity of subjective disorders, i.e. the attack of vibration-induced white fingers. The obstructive form and loss of amplitude of the pulse wave form are accepted as pathological.


[Potential genotoxic effects of cytostatics in occupationally-exposed persons].

The aim of the study was to determine possible mutagenic implications of occupational exposure to cytostatic agents. Twenty-one nurses handling antineoplastic drugs and a matching control group were examined. The conventional method for testing chemical mutagens, that of sister chromatid exchanges, SCE, was used. Although the results obtained in the exposed group did not significantly differ from those obtained for the controls, wide ranges of SCE values observed among the medical personnel handling cytostatic drugs confirm the suspicion of the genotoxic effect of those agents.


[Late changes in renal function after lead poisoning and chelation therapy].

Glomerular filtration rate was examined by determination of creatinine clearance in 22 adult males with a past history of lead poisoning. Eighteen subjects had been poisoned after many years of occupational exposure to lead and four had been poisoned by ingestion of alcohol beverage kept in lead-glazed pots. Seventeen subjects were treated with the chelating agent calcium-disodium-edetate (CaNa2EDTA), the remaining five received no treatment. The aim of the study was to examine the delayed effects of lead poisoning on kidney function and the possible difference in functional impairment between the treated and the non-treated subjects. The results obtained demonstrated a significantly reduced glomerular filtration rate, adjusted for age, in subjects poisoned by lead in the past who failed to receive specific treatment (P < 0.01). This indicates the possibility of marked, delayed adverse effect of lead on the kidneys in cases when lead body burden has not been reduced by treatment.


[Radioactive contamination of cistern waters along the Croatian coast of the Adriatic Sea].

Measurements of radioactive contamination of cistern waters with 90Sr, 134Cs and 137Cs have been carried out along the Croatian coast of the Adriatic Sea. An exponential decline of radioactivity followed the moratorium on nuclear tests. After the nuclear accident at Chernobyl, high radioactivity levels were detected again. The pre-Chernobyl and the post-Chernobyl mean residence times of 90Sr in cistern waters reflect the mechanism by which strontium was released to the atmosphere (atmospheric nuclear weapon tests conducted in the stratosphere or explosions in the Chernobyl nuclear reactor releasing radioactive material to the troposphere). For the pre-Chernobyl period, the mean residence time of 90Sr in cistern waters was similar to that calculated for fallout, being approximately 10 years. The post-Chernobyl 137Cs/90Sr activity ratio has been decreasing, but it has not yet reached the pre-Chernobyl values (approximately 1.6). The time-dependent 134Cs/137Cs activity ratio reflects the Chernobyl reactor inventory of these radionuclides. The annual dose for the critical adult population received from 90Sr, 134Cs and 137Cs by consumption of cistern water was estimated to be a few percentages of the dose from natural background radiation.


[Monitoring of respiratory symptoms and pulmonary ventilatory function in sisal processing workers].

The prevalence of acute and chronic respiratory symptoms and ventilatory capacity was studied in 50 textile workers exposed to sisal dust. A follow-up study was performed 19 years later and included 20 workers out of the 50. The first study showed a considerably higher prevalence of all chronic respiratory symptoms in the exposed than in control workers although the difference was statistically significant only for chest tightness (P < 0.01). Comparison of the prevalence in the first and the follow-up study in 20 textile workers revealed a statistically significant increase in the rate of chronic cough, dyspnea, chest tightness and nasal catarrh. During the follow-up study the prevalence of almost all chronic respiratory symptoms was significantly higher in exposed than in control workers. Results of ventilatory capacity in 50 sisal workers showed acute reductions of FVC and FEV1 during work shift on Monday and the following Thursday. Comparison of the measured and predicted normal values demonstrated lower values in the follow-up study in comparison to those in the first study. The mean annual fall of ventilatory capacity tests was 0.027 L for FVC and 0.036 L for FEV1. Data suggest that long-term exposure to sisal dust may cause the development of chronic respiratory symptoms and lung function impairment in sensitive subjects.


Psychosocial work environment in relation to changes in selected biochemical parameters in district nurses.

Sixty-four female district nurses between the ages of 25 and 60 in the greater Stockholm area were subjects in a longitudinal study of psychosocial work environment and biochemical serum parameters. Each participant filled out questionnaires and had blood drawn on four different occasions at three-month intervals during one year. The rating on the fourth occasion showed psychosocial work environment to have deteriorated--social climate and authority over decisions were significantly inferior to those on previous occasions. These changes were accompanied by small but significant elevations of serum cholesterol, calcium and triglycerides. Another pattern was also observed which was probably due to increased health habit awareness--a progressive decrease in glycated haemoglobin and gamma glutamyl transferase. No significant interactions were observed with age or smoking habits--old and young subjects did not differ in their change patterns over time, nor did smokers in respect to non-smokers.


Interconvertibility of asbestos fibre count concentrations recorded by three most frequent methods.

Simultaneous airborne chrysotile asbestos fibre samples were collected with three types of instruments, namely, the konimeter, the thermal precipitator and the membrane filter, in four asbestos plants (textile manufacturing, asbestos cement production, mining, milling). Linear regression analyses were performed of the membrane filter on the konimeter and thermal precipitator count concentrations, respectively. Sampling was performed at 24-35 locations in each of the processes studied. In order to linearize the relationships and to stabilize the sample variances the data were transformed using the transformation ln(x+1) for both the predictor and the response variables. Eight linear regression equations were developed. The slope coefficients of regressions differed significantly (P < 0.05 or < 0.01) between all the asbestos processes except for the differences of coefficients in mining and milling (P > 0.05). It is concluded that no single conversion factor can be used to reliably convert the konimeter or thermal precipitator to membrane filter asbestos fibre concentrations; a separate conversion factor must be derived for each technological process. In this case the confidence limits of estimates are acceptable for practical occupational hygiene purposes.


Animal studies related to Balkan endemic nephropathy.

Basic field studies related to the animal population were performed in the region of Slavonski Brod, Republic of Croatia, where Balkan endemic nephropathy is an endemic disease. Pathological changes in several animal species from the locality were examined. The pig population in the area is numerous. Morphologically and physiologically pigs make an excellent animal model for studies of human diseases. Their use in studies should be encouraged, especially because there is a possibility that pigs and humans suffer from the same type of intoxication with a specific xenobiotic of natural origin. According to the mycotoxin theory about the aetiology of Balkan endemic nephropathy, pork meat might be one of the possible hazards for humans. Experiments on laboratory animals provide an excellent possibility to monitor several aspects of pathogenesis and all stages of pathomorphological changes which might then be correlated with Balkan endemic nephropathy. However, the experimental species should be critically chosen because some spontaneous, species-specific lesions of the kidneys are easily mistaken for changes induced experimentally.


Tetrahydrobiopterin-dependent formation of endothelium-derived relaxing factor (nitric oxide) in aortic endothelial cells.

Inhibition of tetrahydrobiopterin (H4biopterin) biosynthesis in endothelial cells almost completely abolished the agonist-induced formation of endothelium-derived relaxing factor (EDRF) (NO). This inhibitory effect could be antagonized when H4biopterin biosynthesis was restored by activating a salvage pathway. These data indicate that the formation of EDRF strictly depends on the presence of intracellular H4biopterin, which, in addition to Ca2+, may represent a further physiological and/or pathophysiological regulatory of endothelial NO synthases.


A functional model of the human cardiac ventricle.

A quantitative model is presented which accurately reproduces the time activity curve of the human left ventricular blood pool. Four parameters receive numerical values and may be of clinical value.


Assistive technology device use in patients with rheumatic disease: a literature review.

Occupational therapists often prescribe assistive technology devices (ATDs) to assist persons with disabilities in performing daily living tasks. Estimates suggest that although most ATDs are used, a substantial proportion are never used or are discarded shortly after they are obtained. A review of the literature on ATDs was carried out to identify factors that contribute to ATD use and disuse. The review focused on persons with osteoarthritis and rheumatoid arthritis, because such persons are frequent users of ATDs. Although the literature review highlighted person-, environment-, and ATD-related factors as relevant to ATD use, it also underscored the dearth of scientific study of the prescription, provision, and use of ATDs. A model is proposed to guide empirical research aimed at identifying non-device users from the outset of treatment so that interventions to improve ATD use may be initiated or alternative interventions implemented. The variables comprising the model pertain to the patient, the patient's living environment, the therapist prescribing the device, and the device itself.


[The fourth centenary of Montaigne's death. February 28, 1533-- September 13, 1592. Mysteries of procreation].

During millennia, the mechanisms of procreation have constituted for man an unfathomable and irritating riddle. In the sixteenth century, mystery remained still untouched upon and Montaigne complained about it. The author assigns a place to his communication within the celebrations held this year to commemorate the fourth centenary of the writer's death. In the seventeenth century, De Graaf will establish the identity of ovarian follicles and Van Leeuwenhoek will discover spermatozoons, prominent strides, but their functions will remain mysterious. In the eighteenth century, Spallanzani will demonstrate the semen's fertility, but without linking the former discoveries. In the nineteenth century only, the mechanisms of fertilization will tell their secret, when the necessity of the union of the two gametes, indispensable condition so that the egg can divide by bipartition and give birth to an embryo which will have the double heredity of origin, will be shown up.


Induction of peroxisomal beta-oxidation enzymes by dehydroepiandrosterone and its sulfate in primary cultures of rat hepatocytes.

Treatment of cultured rat-hepatocytes with 50 microM dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) for up to 5 days resulted in a progressive increase in peroxisomal beta-oxidation and carnitine acetyltransferase activity. After 5 days, the increases in activity were 2.6- and 4.8-fold for peroxisomal beta-oxidation and 11.7- and 17.1-fold for carnitine acetyltransferase over the initial activity, in DHEA- and DHEAS-treated cells, respectively. The stimulation of the activity of these enzymes by the respective agents was dose-related; it was maximum with 50 to 100 microM DHEA and 50 to 250 microM DHEAS, although DHEAS was more effective for stimulation than DHEA. Western blot analyses revealed the induction of acyl-CoA oxidase, enoyl-CoA hydratase/3-hydroxyacyl-CoA dehydrogenase bifunctional enzyme and carnitine acetyltransferase in the treated cells. Moreover, induction of fatty acid omega-hydroxylase proteins (P-450IVAS) was also revealed. These results indicate that DHEA and DHEAS act directly on hepatocytes. The induction of hepatic peroxisomal beta-oxidation enzymes and several other enzymes in rats administered with DHEA could be accounted for, at least in part, by the direct action of DHEA and its sulfate-conjugate (DHEAS) on liver cells.


Monte Carlo simulation studies on the prediction of protein folding types from amino acid composition.

In the methodology development for statistical prediction of protein structures, the founders of different methods usually selected different sets of proteins to test their predicted results. Therefore, it is hard to make a fair comparison according to the results they reported. Even if the predictions by different methods are performed for the same set of proteins, there is still such a problem: a method better that the other for one set of proteins would not necessarily remain so when applied to another set of proteins. To tackle this problem, a Monte Carlo simulation method is proposed to establish an objective criterion to measure the accuracy of prediction for the protein folding type. Such an objective accuracy is actually corresponding to the asymptotical limit genereated during the Monte Carlo simulation process. Based on that, it has been found that the average objective accuracy for predicting the all-alpha, all-beta, alpha + beta, and alpha/beta proteins by the least Euclid's distance method (Nakashima, H., K. Nishikawa, and T. Ooi. 1986. J. Biochem. 99:152-162) is 73.0% and that by the least Minkowski's distance method (Chou, P.Y. 1989. Prediction in Protein Structure and the Principles of Protein Conformation. Plenum Press. New York. 549-586) is 70.9%, indicating that the former is better than the latter. However, according to the original reports, the latter claimed a rate of correct prediction with 79.7% but the former with only 70.2%, leading to a completely opposite conclusion. This indicates the necessity of establishing an objective criterion, and a comparison is meaningful only when it is based on the objective criterion. The simulation method and the idea developed here also can be applied to examine any other statistical prediction methods.


Mechanisms of meat batter stabilization: a review.

Comminuted meat products are a complex mixture of muscle tissue, solubilized proteins, fat, salt, and water. The two theories that have been presented to explain meat batters stabilization are reviewed. The emulsion theory explains stabilization by the formation of a protein film around fat globules, whereas the physical entrapment theory emphasizes the role of the protein matrix in holding the fat in place during chopping and subsequent heating. However, some aspects of stabilization cannot be explained adequately by either one of these theories. In this article the role of meat proteins, aqueous phase, and lipid phase are examined in light of past and recent research findings.


Food legumes in human nutrition: a personal perspective.

Perhaps with the notable exception, and that only in recent years, of red meat, which contributes dietary saturated fats and cholesterol, two well-known reasons in the etiology of heart-related disorders, no single group of foods has been portrayed in such negative terms as the food legumes traditionally have been during the last 50 years of research in food science and human nutrition. Even more alarming are the trends of continued research on such aspects as the deficiency of sulfur-amino acids (both by amino acid analyses as well as rat feeding studies), and the heat lability/stability of proteinase inhibitors and phytohemagglutinins in various legume species. A survey of literature indicates that over 100 research papers were published during the 1981 to 1990 period alone, in just three journals (Journal of Food Science, Journal of Agriculture and Food Chemistry, and Journal of the Science of Food and Agriculture) having the highest citation ratings in food sciences on these three topics, with a general consensus about the facts that were well established as early as the late 1950s. Considering the proliferation of journals publishing food science and human nutrition related work, especially in the Third World countries, the actual number probably would be much higher. This trend also indicates that we are repeating certain aspects of research on the importance of food legumes in human nutrition. Are we really any closer today in our understanding and appreciation of why the nomadic human made such a choice for their very existence during the transition to a more civilized society? This is a high time to project the image of legumes in human nutrition in proper perspective. The validity of our continued research on certain aspects of legumes in human nutrition, at a time when worldwide the research dollars are becoming increasingly harder to come by, is challenged in this review. Essentially, it is a journey through the author's personal diary that raises several questions in justifying the continued research support for at least some nutrition-related work on legumes and an account of what research areas perhaps need to be targeted in the 21st century.