Voluntary modulation of neutrophil adhesiveness using a cyberphysiologic strategy.

In a study of voluntary immunomodulation, 45 subjects were assigned either to a control group or one of two experimental groups. All groups had blood and saliva samples collected before and after either a 30 minute rest condition (Control group) or a 30 minute cyberphysiologic strategy (Experimental groups) to increase neutrophil adherence. These samples were analyzed on a range of immunologic measurements including neutrophil adherence. The second experimental group practiced a cyberphysiologic strategy two weeks prior to the experimental session. Subjects in each group returned to repeat their exercise in a second session the following week. Analysis of all immune measurements revealed statistical significance for changes in neutrophil adherence. These studies suggest that such strategies may be used to effect changes in immune cell functions. Analysis further revealed that those subjects with prior cyberphysiologic training were able, by the second session, to induce a significant increase in neutrophil adherence.


Potentials associated with the initiation and inhibition of visually triggered finger movement in humans: the "no-go potential" in the go/no-go paradigm.

Surface event-related potentials associated with visually triggered movements (Go) and the inhibition of planned movements (No-Go) of the right index finger were examined in seven normal healthy subjects. Subjects' response priming was manipulated by presenting two sessions which either emphasized the Go condition (50 go trials vs. 30 no-go trials) or the No-Go condition (30 go trials vs. 50 no-go trials). Stimulus-locked waveforms showed enhanced components (P1-N1, N2, N1-P300) for the No-Go trials particularly in the response priming which emphasized the Go condition. It is suggested that the inhibition of planned movements is associated with surface negativity which trails the sensory P1-N1 potential yet may partially overlap it and therefore influence its amplitude. This "no-go" potential is dependent on the response priming of the subject and is most apparent when fast responses are planned and then arrested.


The brain in fractal time: 1/f-like power spectrum scaling of the human electroencephalogram.

"1/f-like" power spectrum scaling is a ubiquitous feature of complex systems. In such scaling, the power spectrum of a given time series is dominated by an inverse power law, resulting in an inverse linear relation between log power and log frequency. The 1/f-like power spectrum scaling properties of human, resting eyes-closed and eyes-open EEG were examined. For both eyes-closed and eyes-open EEG, log power had a significant inverse linear relation with log frequency. The slope of this relation was not correlated with previously-calculated Grassberger-Procaccia dimension estimates for the same data, indicating that the EEG is not a 1/f-like stochastic process. Further, the degree of deviation from perfect log power versus log frequency linearity was related to power in the 8-12 Hz alpha frequency band. It is speculated that this deviation may be related to the low dimension of a chaotic alpha rhythm relative to other EEG rhythms.


Pattern reversal visual evoked potentials (PVEPs) in transient ischemic attacks (TIAs) and prolonged reversible ischemic neurological deficits (PRINDs) of anterior circulation with normal EEGs and normal cranial CTs.

Out of 75 patients with TIA or PRIND we selected 9 TIAs and 6 PRINDs with normal EEGs and CCTs, full recovery of neurological function, no history of amaurosis fugax and no findings of visual impairments. PVEPs were derived from 01-02 to Fz and Cz as ground following binocular pattern reversal visual stimuli of 1.9 Hz. Interhemispheric differences of the latencies of P60, N80, P100 and of the amplitudes N80/P100 and P100/N140 were compared with the corresponding parameters of 22 age matched controls. In contrary to the latency differences the interhemispheric difference of the amplitude N80/P100 was highly significantly larger (33.5 +/- 16.0%) in patients than in the control group (12.8 +/- 9.8%) (p < or = .0005). The amplitude P100/N140 behaved the same way (p < or = .025); the amplitude of the affected side being smaller. There were no statistical differences between TIAs and PRINDs and a tendency was seen for normalization of the differences with increasing time distances between the onset of the ischemic attack and the point of time of the recordings.


Relationship of serum zinc levels to hand preference, skull length and serum gonadal hormone levels in right-handed young adults.

The association between serum zinc (Zn) level and the degree of hand preference was studied in right-handed young adults. Hand preference was scored by the Waterloo Handedness Questionnaire. Serum Zn level was determined by the flow injection analysis-atomic absorption technique. Zinc was found to be positively linearly and significantly correlated with the degree of right hand preference in the sample of males with familial sinistrality (FS+) and FS- females with right eye and right foot preference. There was a negative linear correlation between these variables in FS+ females. Skull length showed a significant negative linear correlation with zinc in FS+ males and females, but a positive linear correlation in FS- females. In FS- females, there was a significant positive linear correlation between serum gonadal hormone binding globulin (GBG) and serum Zn levels. In FS+ males, there was a significant negative linear correlation between serum GBG and Zn levels, and a significant positive linear correlation between serum free testosterone level and serum Zn level. It was suggested that zinc may influence the degree of the right hand preference by hormonal mechanisms according to genetically established brain organization.


Testosterone and estradiol in right-handed men but only estradiol in right-handed women is inversely correlated with the degree of right-hand preference.

Relations of sex hormones to the degree of right-hand preference was studied in right-handed male and female adult subjects. Hand preference was assessed by the Edinburgh and Waterloo Handedness Questionnaires. Males consisted of weakly, moderately, and strongly right-handed subjects. Females comprised only moderately and strongly right-handed subjects. In females, only serum estradiol was found to be negatively linearly and significantly correlated with the degree of right-hand preference. In males, testosterone, as well as estradiol, showed a significant negative linear correlation with the degree of right-hand preference. Sex hormone binding globulin also showed a similar relation to hand preference in males. Thus, nearly all sex hormones caused a decrease in the degree of right-hand preference in males, whereas only estradiol had the same effect on hand preference in females. This would be the cause of stronger right-hand preference in females than males and vice versa.


Luria's approach to neuropsychological assessment.

A. R. Luria's approach to neuropsychological assessment was examined. Three basic points of departure from Luria are presented: his interpretation of cognitive activity as functional systems, his emphasis on the individualized approach, and the importance of the analysis of the errors. A distinction was introduced between Luria's neuropsychological testing, and Luria's neuropsychological approach; the former refers to the specific set of neuropsychological tests Luria used and developed and the latter, to the specific clinical use of these tests. It is emphasized that Luria's basic contribution to assessment in neuropsychology, refers to the clinical approach he proposed and developed. Problems related to the normalization and validity of neuropsychological tests are analyzed. It is concluded that different approaches in neuropsychological assessment are related to the specific goals for which neuropsychological assessment is performed.


Visual evoked potentials, attention and mnemonic abilities in children.

We analyzed the correlation between attention and mnemonic processes and different visual evoked potential (VEP) parameters. A group of 34 children between 9 and 13 years old was studied. VEPs were recorded in C3, C4, P3, P4, O1, O2, T5 and T6 with linked ear lobes as reference. Two different types of stimuli were used: flash and checkerboard pattern. The power of VEPs was calculated as the sum of the square amplitude values for different time epochs. Correlation coefficients between left and right homologous VEPs were also computed. A visual selective attention task divided into 5 items of increasing difficulty and the Sternberg paradigm were applied. The performance was automatically evaluated by the computer, giving the number of correct responses (NCR) and other measures of performance. Correlation coefficients between VEP parameters and the scores obtained in the performance of tasks were calculated. It was observed that power in P3, P4, T5, and T6 and the correlation coefficients between central, parietal and temporal VEPs were positively correlated with NCR of both tasks. However, power in O1 and O2 was negatively correlated with NCR.


Lateralization of the epileptogenic focus by computerized EEG study and neuropsychological evaluation.

The localization of the epileptogenic focus relies on different factors. In patients with partial seizures, asymmetries in EEG background activity were measured by a statistical evaluation of spectral data. Neurophysiological results were compared with neuropsychological findings and MRI. Fifteen of 22 patients showed asymmetries in EEG background activity. The most prominent abnormality was a statistically significant increase of slow activity observed in 59% of cases. Delta asymmetry coincided with the site of lesions, evidenced by MRI, in 83% of patients; with the site of decreased beta activity in 60% and with the maximum level of spiking activity in 58% of cases. Neuropsychological tests showed a lateralization of the hemispheric function which coincided with delta asymmetry in 33% of patients. These results suggest that the EEG background activity, when compared with other parameters, may represent a useful method in lateralizing the epileptogenic focus.


Amine accumulation: a possible precursor of Lewy body formation in Parkinson's disease.

It is now well recognized that the hypothalamus is an important site of neuropathology in Parkinson's disease (PD). Lewy bodies, a marker of nerve cell degeneration and a pathological hallmark of PD, have been observed frequently in the hypothalamus of PD patients by Lewy (1923) and other investigators and confirmed by more recent systematic studies by Langston & Forno (1978). Both Lewy and Langston & Forno found a predilection of Lewy body formation in specific hypothalamic nuclei with the tuberomammillary, lateral, and posterior areas containing by far the highest average counts per nucleus. Selective vulnerability of the tuberomammillary, lateral, and posterior hypothalamic cell groups to degeneration has been observed also in aging, postencephalitic Parkinsonism, Alzheimer's disease, and schizophrenia. The susceptibility of these particular nuclei to degenerative changes including Lewy body formation is not presently understood nor are the mechanisms by which Lewy bodies are formed in PD and other CNS disorders. Accumulation of amines, a pathological process which follows degeneration of catecholamine-containing neurons in experimental animals, also occurs most frequently in the lateral and posterior hypothalamic areas. In the present communication we propose that in PD, amine accumulation may be a precursor to Lewy body formation and that the susceptibility of certain hypothalamic areas to Lewy body formation may be related to their propensity to accumulate amines. Furthermore, the frequent co-existence of Lewy bodies and Alzheimer's neurofibrillary tangles in the lateral and posterior hypothalamic nuclei suggest that they may share a common pathogenetic etiology. If confirmed, this hypothesis may provide an experimental model by which the formation of Lewy bodies and neurofibrillary tangles may be investigated.


Attenuation of epilepsy with application of external magnetic fields: a case report.

We have previously demonstrated that magnetoencephalographic (MEG) brain measurements in patients with seizure disorders show significant MEG activity often in the absence of conventional EEG abnormalities. We localized foci of seizure activity using the mapping technique characterized by the ISO-Spectral Amplitude (ISO-SA) on the scalp distribution of specified spectral components or frequency bands of the emitted MEG Fourier power spectrum. In addition, using an electronic device, we utilized the above recorded activity to emit back the same intensity and frequency of magnetic field to the presumed epileptic foci. Using this method we were able, over the past two and one-half years, successfully to attenuate seizure activity in a cohort of over 150 patients with various forms of epilepsy. We present a patient with severe epilepsy and behavioral disturbances in whom application of an external artificial magnetic field of low intensity produced a substantial attenuation of seizure frequency which coincided with an improvement in the patient's behavior. This case demonstrates that artificial magnetic treatment may be a valuable adjunctive procedure in the management of epilepsy.


Differential effects of left versus right seizure focus on human hippocampal evoked responses.

Hippocampal evoked potentials were recorded using the P3 tonal oddball paradigm in 30 patients with unilateral temporal lobe seizure focus. Spectral power of the evoked potentials was decreased on the side of seizure focus, but this reduction was much greater when the focus was on the left. The effect of left/right focus does not appear to be due to group differences in age, sex, seizure duration, or operative pathology. Remote or finer left/right structural differences or differential left/right hippocampal processing for the sequential tonal task are possible explanations.


Weak magnetic fields in the treatment of Parkinson's disease with the "on-off" phenomenon.

Application of external weak magnetic fields recently has been reported to be efficacious in the treatment of a 62-year-old patient with idiopathic Parkinson's disease (PD) complicated by levodopa-induced fluctuations in motor response ("on-off"). I report an additional case of a 67-year-old man with idiopathic PD and levodopa-related motor fluctuations who likewise experienced marked and sustained improvement in Parkinsonian symptoms and amelioration of "on-off" symptoms following the application of external weak magnetic fields. Based on these observations it is concluded that artificial weak magnetic fields may be beneficial for the treatment of PD complicated by levodopa-related "on-off" phenomenon. Furthermore, since in experimental animals external magnetic fields alter the secretion of melatonin, which in turn has been shown to regulate striatal and mesolimbic dopamine-mediated behaviors, it is proposed that the antiParkinsonian effects of weak magnetic fields are mediated via the pineal gland.


The development of the perichondrium in the avian ulna.

The development of the perichondrium surrounding the ulna of chick embryos was examined between stages 26 and 34 (Hamburger & Hamilton, 1952), i.e. 5.5-8 d of incubation. The first appearance of a barrier between cartilage and adjacent tissue was observed at stage 27 when cells were arranged circumferentially around the central flattened core, but no true perichondrium was seen until chondrocyte hypertrophy began at stage 30. At this stage, cells in the barrier became elongated parallel to the long axis of the rudiment and overlapped. With further cell hypertrophy, the perichondrium consolidated and by stage 31 a distinct, compact structure, several cells thick and exhibiting cell-cell contacts had formed around the hypertrophic cell region. By stage 32, overlapping perichondrial cells could be seen surrounding the flattened cell region and this structure consolidated as cell hypertrophy spread from the centre towards the ends of the rudiment. The rounded cell zone at the epiphyses never formed a distinct perichondrium during the time course of this study. This differential structure of a compact perichondrium surrounding the hypertrophic cell region, a loose perichondrium surrounding the rounded cell region and an intermediate perichondrium surrounding the flattened cell region may facilitate the morphogenesis of the rudiment by acting as a constraining sheath restricting radial expansion but favouring longitudinal expansion.


Immunomodulation of low dose streptozocin diabetes in mice reveals that insulitis is not obligatory for B cell destruction.

Twenty male C57Bl/J mice were injected with 50 microliters complete Freund's adjuvant (CFA) 1 wk before and 1 wk after induction of diabetes with 45 mg streptozocin (STZ)/kg body weight i.p. over 5 d. CFA administration prevented islet infiltration. Inflammatory cells were not seen within any of the islets observed. However, islet B cell destruction still occurred. These cells showed evidence of considerable damage, containing swollen mitochondria, contracted nuclei and areas of vacuolation and degranulation. Inflammation is therefore not obligatory for the development of low dose STZ induced diabetes.


An electron microscopic and morphometric study on the GABA-immunoreactive terminals in the cuneate nucleus of the rat.

Immunogold labelling was used to identify GABA-immunoreactive (GABA-IR) terminals in the cuneate nucleus of the rat. About 30% of the terminals surveyed were GABA-IR. They were mostly small, although a few of medium size were encountered. The terminals contained either polymorphic or round synaptic vesicles; these occurred in an approximately 5:1 ratio. Most of these terminals formed symmetric synapses with dendrites of various sizes. The GABA-IR terminals also made synaptic contacts with somata of cuneate neurons and axon terminals of unknown origin. In addition, a few GABA-IR terminals forming asymmetric synapses were found in the cuneate neuropil. The possible functional significance of the synaptic organisation is discussed.


Biometry of the anterior border of the human hip bone: normal values and their use in sex determination.

Sixteen different variables and 3 indices for the anterior border of 42 human hip bones from a Spanish skeletal collection were studied. Values for 15 of these variables and for the 3 indices are reported. We were unable to detect statistically significant differences between means relating to side in any of the variables and indices studied. Statistically significant differences were detected between means in relation to sex for 4 variables (distance from the anterior superior iliac spine to the pubic tubercle, distance from the anterior inferior iliac spine to the iliopubic eminence, distance from the anterior inferior iliac spine to the pubic tubercle, length of the notch between the anterior inferior iliac spine and the iliopubic eminence). These variables could be used for sex determination from the human hip bone or its fragments.


A quantitative and morphometric study of the transformation of amoeboid microglia into ramified microglia in the developing corpus callosum in rats.

The morphometric and quantitative changes associated with the differentiation of amoeboid microglia into ramified microglial cells in the corpus callosum of rats between 21 d postconception (E21) and 15 d postnatally are described. Using lectin labelling, 5 morphological types of labelled cells (R, SP, KLP, TLP, AP) based on cell body shape, the configuration of their cytoplasmic processes and their staining intensity, were recognised. Round cells (R) and cells with stout processes (SP) were aggregated in the central part of the developing corpus callosum whereas the highly branched labelled cells were distributed at its periphery. When the morphometric data and labelling intensities of labelled cells were analysed with the aid of an image analysis system, the values for cell length, area and perimeter increased as the complexity of branching increased, whereas the lectin-labelling intensity became reduced. Quantitative study showed that the proportion of the different morphological types of lectin-labelled cells peaked at different ages. The sequential peaking of R, SP and highly branched cells with advancing age suggests a similar chronological order of differentiation of R into branched cells. The quantitative study also showed a rapid increase in the density of lectin-labelled cells in the postnatal period between P4 and P8, attributed primarily to the active proliferation of the cell type. The consequent reduction of cell density (after P13) was probably due to cell death, a feature which appeared to increase with development.


An immunohistochemical study of human postnatal paraganglia associated with the urinary bladder.

Histological and immunohistochemical methods were used to study pelvic paraganglia in a series of human postnatal specimens ranging in age from 1 month to 6 y. Up to 5 months of age, many of the encapsulated paraganglia contained small pacinian-like sensory corpuscles which occurred either singly or in small clusters, implying an unknown functional interrelationship during this period. In older specimens, this intimate association was not observed since pacinian corpuscles and small nonencapsulated clusters of paraganglion cells were observed only as separate structures. It is suggested that the paraganglion cells may induce the formation of the pacinian corpuscles during fetal development. Immunohistochemistry using the nerve marker protein gene product (PGP 9.5) demonstrated a rich plexus of varicose nerve fibres within the paraganglia which may directly innervate the paraganglion cells and/or be associated with the profuse vascular supply. A similar density of vasoactive intestinal polypeptide-containing nerves was also demonstrated while some of the nerves contained calcitonin gene related peptide or substance P. The paraganglion cells stained positively for tyrosine hydroxylase, dopamine-beta-hydroxylase and neuropeptide Y, but not for phenylethanolamine N-methyltransferase. This combination of immunostaining confirms them as a rich source of noradrenaline.


An investigation of the migratory potential of mouse oocytes in vitro.

This investigation was undertaken to determine the potential of mouse oocytes for migratory activity using bisected ovaries in vitro. Bisection allowed larger medullary oocytes to be brought nearer to the surface; in this way the migratory potential of all oocytes could be studied. Observations were made following 48 h culture to allow for recovery from any initial traumatic effects resulting from bisection. Ovaries were explanted from fetuses at d 15 postcoitum and from neonatal and postnatal mice (d 1-7, 11, 12 and 14 of life) and examined by scanning and transmission electron microscopy. Oocytes were extruded from the surface and a sequence of events was inferred. Cells superficial to the oocyte sloughed off, exposing the oocytes which showed the migratory phenotype as they emerged onto the surface. Here each oocyte became rounder and was finally extruded, leaving a 'crater'. Scanning electron microscopy of the explant surface allowed counts to be made of emergent oocytes. The number of explants showing emergent oocytes was at a maximum when ovaries were removed at the end of the first week postnatum; the mean number of oocytes emerging from each also peaked at this time. Numbers of migratory oocytes declined in ovaries aged 11 d at explantation and by d 14 only 66% of explants showed oocytes at the surface. The distribution of oocytes of various sizes at the surface suggests that both small cortical oocytes and larger medullary oocytes can express the migratory phenotype. Transmission electron microscopy verified structural integrity of the emerging oocytes and revealed their relationship to underlying cells.


Blood supply of the articular disc of the antebrachiocarpal joint in dogs.

The normal vascular anatomy of the articular disc of 48 antebrachiocarpal joints was studied in 24 dogs (12 puppies and 12 adult animals) using an India ink vascular injection technique. It was found that the articular disc receives its blood supply mainly from the palmar and dorsal branches of the palmar interosseous artery. Branches of these 2 arteries arborise and give direct peridiscal vessels to the dorsal, proximal and palmar sides of the articular disc. The peridiscal vessels ramify and anastomose with one another to form a cup-shaped terminal peridiscal capillary plexus around the disc which ends at the peripheral parts of the disc in a series of terminal capillary loops. This leaves the major central segment of the disc without blood vessels. The proportion of vascularised to nonvascularised areas of the disc depends upon the age of the animals. In young puppies, the degree of vascular penetration into the disc is quite extensive, while in adult animals it ranges from 15 to 25% of the discal width; the considerably larger central area of the articular disc is thus avascular.


Histological features of the dorsal cortex of the third metacarpal bone mid-diaphysis during postnatal growth in thoroughbred horses.

The dorsal cortex of the equine third metacarpal mid-diaphyseal bone was characterised during growth by the histological and microradiographic examination of specimens from 30 horses ranging in age from 2 months to 8 y. Bone from horses aged less than 6 months was characterised by rapid periosteal apposition of circumferential trabeculae of woven bone that were next connected by radial trabeculae to the parent cortex. Deposition of lamellar bone on the inner trabecular surfaces resulted in rows of primary osteons. Replacement of primary bone occurred only after 4 months of age and preferentially in the woven interstitial bone separating rows of primary osteons formed in the postnatal periosteal cortex. Resorption cavities and incompletely filled secondary osteons characterised bone of 1 and 2-y-old horses. Bone from horses older than 3 y contained several generations of secondary osteons, fewer resorption spaces and incompletely filled osteons, and had a greater portion of circumferentially oriented collagen fibres than bone from younger horses. Bone from horses older than 5 y had large resorption cavities characterised by irregular boundaries. We propose that the process of periosteal bone tissue apposition observed in growing foals be called 'saltatory primary osteonal bone formation' and that this process results in faster cortical expansion and larger total surface area for bone deposition than circumferential lamellar, simple primary osteonal, and plexiform mechanisms of periosteal bone formation. We speculate that bone from 1 and 2-y-old horses would be more susceptible to fatigue microdamage resulting from compressive loads because of high porosity, few completed secondary osteons and low proportion of circumferentially oriented collagen fibres.


Immune response following vasectomy in the rat: a study of the stimulation of the regional lymph node.

Following vasectomy, sperm granulomas are generally believed to be important sites of access of spermatozoal antigens to the immune system. This study tests the validity of that assumption by grafting tissues from a sperm granuloma to an ectopic site (the scrotal skin) and studying the effect on the regional (inguinal) lymph node. Xiphoid cartilage provided the graft material in control animals. The experimental lymph nodes showed significant increases in weight and in the number of sectional profiles of cortical nodules indicating that they were stimulated by the presence of the granuloma tissue. To investigate the mechanism of lymph node stimulation further, a group of rats underwent unilateral vasectomy followed after 7 wk by ipsilateral orchidectomy. Three months after the initial operation the histological features of the regional (left renal) lymph node of the epididymis and granuloma were compared with corresponding nodes from rats 3 months following unilateral vasectomy only and following sham operation. The results indicate that continuous sperm production is required to sustain activity of the regional lymph nodes despite the continued presence of spermatozoa in the sperm granuloma.


Ultrastructural aspects of oocyte growth in the marsupial Monodelphis domestica (grey short-tailed opossum).

The growth of the opossum Monodelphis oocyte does not correspond to the strict biphasic pattern so far described in eutherians and marsupials. The oocyte increases appreciably in size during the last stage of antral follicle development. During the primordial and primary follicle stage Balbiani bodies or paranuclear complexes are not detectable in Monodelphis oocytes. Organelles are randomly distributed. In addition to the nucleolus, perichromatin and ribonucleoprotein particles are other intranuclear structures which occur as regular components in the early Monodelphis oocyte. Clusters of particles are mostly seen in close association with the nuclear envelope. Similar material has been encountered in the cytoplasm as a type of freely-existing 'nuage' material but never as mitochondria-associated 'nuage' or 'cement'. Both types of particles, intranuclear and cytoplasmic, disappear by the time antral follicle formation begins. Mitochondria are at first of the typical transformed shape seen in most mammalian oocytes. They are large, round or oval in outline with a few, often arched, cristae and a light matrix. During the primary follicle stage, mitochondrial size and complexity decrease and the matrix becomes electron dense. A close relationship between mitochondria and endoplasmic reticulum appears early in the primordial and later in the primary follicle oocyte. Regularly detected structures in the ooplasm of preantrum oocytes are paired or 'confronting' cisternae of endoplasmic reticulum, which are lamellar complexes comprised of 2 or more parallel cisternae with intervening electron-dense material. The most conspicuous inclusions in the Monodelphis oocytes of the tertiary and graafian follicles are vesicles. All other organelles are confined to the peripheral zone of the oocyte. Golgi and endoplasmic vesicles both take part in the formation of multivesicular bodies which seems to be the starting point for the vesicle accumulation. Further increase in size involves the incorporation of endocytotic vesicles and the coalescence of larger vesicles. Ordinary fixation procedure leave the vesicles empty. Cortical granules are found only in small numbers.


The peripheral course of the axons innervating the medial rectus muscle within the subarachnoid portion of the oculomotor nerve.

There is clinical evidence of topographic localisation of fibres within the oculomotor nerve. It is generally accepted that the pupillomotor fibres have a localised course within the dorsomedial periphery of the subarachnoid portion. However, the precise course of the individual groups of axons innervating each muscle has not been examined in detail. In this study the course of the axons innervating the medial rectus muscle was investigated in the subarachnoid portion of the oculomotor nerve of the rat. The medial rectus muscle was injected with horseradish peroxidase until it was fully infiltrated. The subarachnoid portion of the oculomotor nerve was removed and sectioned longitudinally in the sagittal plane. Sections were reacted with tetramethylbenzidine as a chromogen. Labelled axons were found to be localised in the ventral part of the subarachnoid portion of the nerve.


Innervation of an aberrant digastric muscle in the posterior thigh: stratified relationships between branches of the inferior gluteal nerve.

During dissection of the gluteal region and the posterior thigh, an aberrant digastric muscle was observed on the right side of a 77-y-old Japanese male cadaver. This originated from the sacrotuberous ligament and inserted into the lateral surface of the long head of biceps femoris. Based on its innervation, this aberrant muscle may be homologous with the femorococcygeus.


Unrotated left kidney associated with an accessory renal artery.

During routine dissection, a rare anomaly of the kidneys and their vessels was observed in a 55-y-old male cadaver. The anomaly consisted of an unrotated left kidney with partly extrarenal calyces and pelvis. In addition to its normal artery, the left kidney received a branch originating from the inferior end of the aorta.


Association of nerve fibres with myoid cells in the chick thymus.

The presence of nerve fibres in the medulla of the chick thymus has been investigated ultrastructurally. Unmyelinated nerve fibres were found not only in the perivascular space but also among the myoid cells. The nerve fibres were situated in close proximity to the myoid cells. The unmyelinated axons, containing predominantly clear vesicles and some dense-core vesicles, were found in recesses of the plasmalemma of the Schwann cell. Contacts between nerve fibres and fibroblasts were also observed.


An unusual ulnar nerve-median nerve communicating branch.

Branching of the ulnar nerve distal to the origin of the dorsal cutaneous branch was investigated in 25 hands in one of which an anatomical variation was observed. This finding may be of importance in the evaluation of certain entrapment phenomena of the ulnar nerve or unexplained sensory loss after trauma or surgical intervention in that particular area.


A computerized system for identifying and informing physicians about problematic drug use in nursing homes.

With growing concern over the quality of medication use in nursing homes, physicians, administrators, pharmacists, and regulators are looking for effective and efficient methods to improve it. Pharmacy consultation alone appears to be ineffective in controlling the use of inappropriate drugs. We describe here a computerized drug utilization review system designed for use in nursing homes. The system evaluates the appropriateness of medication use by criteria developed through the consensus of experts in geriatrics and specifically designed to address the pharmacological needs of elderly, nursing home residents. The program not only determines the frequency of inappropriate prescriptions, but produces written, educational statements to be given to prescribing physicians. These statements can also be given to nurses to educate them about issues in geriatrics pharmacology. Additionally, the system produces medication order forms that may help focus physicians' attention on the need to evaluate drugs individually.


Evaluating productivity in clinical research programs: the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP).

This paper outlines an approach to studying productivity in clinical research programs that incorporates environmental, organizational, provider, and patient specific factors in the model of production process. We describe how this approach has been applied to the National Cancer Institute's (NCI) Community Clinical Oncology Programs (CCOPs). Next, a practical evaluative model of the productive process in CCOPs is outlined and its use in evaluation and monitoring performance in CCOPs is discussed. Each level of the model is described and a number of factors potentially affecting each level are explored. Finally, we discuss the strengths and weaknesses of this approach and show how management can use it to study and improve the productivity of clinical research programs.


Forecasting hospital laboratory procedures.

Improved forecasts of hospital laboratory procedures can provide the basis for better resource planning and enhanced operating efficiency. The research reported here-in describes how multiple regression models can be both a source of insight into causal relationships and a tool for achieving accurate monthly forecasts. Past research in this area may have overstated the statistical significance of findings because of a failure to address the potential effect of serial correlation. The present study uses the Cochrane-Orcutt regression procedure, rather than OLS, to overcome this problem. A model using inpatient admissions, acuity days, length of stay, discharge days and seasonal dummy variables is shown to account for 87% of the variation in the number of billable laboratory procedures. A simpler multiple regression model and a Winters' exponential smoothing model were found to provide excellent forecasts for laboratory procedures. In a one year out of sample evaluation, the annual percent forecast error was 0.7% for the regression model. This compares favorably to a percentage forecast error of 11.6% using subjective forecasting methods.


Cost justification of a laboratory information system: an analysis of projected tangible and intangible benefits.

A pre- and postimplementation comparison of tangible and intangible benefits of the laboratory information system are presented. The key activities projected to save costs through work reduction were evaluated as a basis for procuring a laboratory information system. Following implementation and four years of LIS operation the individual activities used for justification were resurveyed. The tangible benefits which were measured prior to LIS justification totaled $153,471.84 per year based upon fiscal year 1985-86 dollars. The objective re-evaluation of these activities four years after implementation and operation resulted in a measured $115,326.93 per year savings. The loss of projected savings is directly related to over estimates in the original justification evaluation and personnel behavior. The intangible benefits projected were all realized including a number of intangible benefits which made a significant impact on several departmental and clinical services at our institution.


TCK: a clinical genetics data collection system.

This work examines the database design and user interface design for a clinical genetics data collection system known as TCK. A specific design goal is automatic generation of the CORN reports. Emphasis in this paper is on how the logical data model resulting from the database design, and the user interface work together to enforce the enterprise results pertaining to data. Data screens are shown, sample queries are explained and the data mapping to the CORN reports presented.


Increase in the activity of alkaline phosphatase by L-ascorbic acid 2-phosphate in a human osteoblast cell line, HuO-3N1.

The activity of alkaline phosphatase (ALPase) was significantly enhanced in a human osteoblast cell line, HuO-3N1, when it was cultured in the presence of L-ascorbic acid 2-phosphate (AsA-P; a stable ascorbic acid derivative). With AsA-P in the culture, the level of ALPase activity increased approximately 3-fold without any effect on either the morphology or growth rate. This increase was dependent on the AsA-P concentration in the range of 0.2-2 mM and required at least 48 h incubation with AsA-P. The ALPase mRNA level, however, remained rather constant irrespective of the enzyme activity. Removal of AsA-P from the precultured medium decreased the stimulatory effect of ascorbic acid on the ALPase activity, indicating that the effect was reversible. Dexamethasone, an inducer for osteoblastic differentiation, enhanced the level of ALPase activity irreversibly, in parallel with the increase in the level of its mRNA. The enhancement of the ALPase activity by ascorbic acid in this cell line appeared to be independent of cell differentiation.


Low copper and brain abnormalities in fetus from triethylene tetramine dihydrochloride-treated pregnant mouse.

The effects of prenatal triethylene tetramine dihydrochloride (Trien-2HCl) exposure on fetal mice have been investigated on gestational day 19. Trien-2HCl was given throughout pregnancy at levels of 0 (control), 3,000, 6,000, or 12,000 ppm as drinking water, ad libitum. At the level of 12,000 ppm, the frequency of total resorption tended to be high and that of fetal viability tended to be low, as compared to controls. Decreased maternal weight was observed in body, but not in liver, at the level of 12,000 ppm. Fetal body and cerebrum weights significantly decreased at the levels of 6,000 and 12,000 ppm; however, fetal liver weight remained unchanged. Maternal serum copper concentration was not affected by the Trien-2HCl. Fetal copper concentrations of liver and cerebrum were significantly lower in the Trien-2HCl-treated groups than in the controls, with levels decreasing in a dose-related manner. When the copper and zinc concentrations in the group treated at 12,000 ppm were compared with those in controls, significant decreases in both metals were observed in placenta but not in maternal liver. Changes in fetal zinc concentration varied by tissues: i.e., an increase in liver and no change in cerebrum. Fetal abnormalities were frequently observed in brain, and the frequency was increased with increasing levels of the Trien-2HCl. These results suggest that fetal brain abnormalities caused by Trien-2HCl may be due in part to induction of copper deficiency, which is almost equivalent to that in brindled mutant mouse.


The effect of spiny lobster shell powder on bone metabolism in ovariectomized osteoporotic model rats.

Calcium has been found to be indispensable in the prevention of osteoporosis. Recently, there has been a great deal of research into the best way to consume calcium. In this study, the effect of "powdered lobster shell" on bone metabolism was examined in ovariectomized osteoporotic model rats. This powder has a good flavor and taste, and contains high quantities of calcium. Six-week-old SD-strain female rats were ovariectomized and were fed a low Ca diet (0.01% Ca and 0.3% P) for 32 days. Thereafter, the rats were divided into two groups; the control group was fed a control diet (0.3% Ca and 0.3% P) and an experimental group, the lobster group, was fed a lobster shell powder diet (0.3% Ca and 0.3% P) ad libitum for 30 days. The results were as follows: in comparison with the control group, the lobster group had significant increases in (1) bone mineral density [BMD (DEXA Hologic's QDR-1000] of lumbar spines and tibial proximal metaphyses, which are mainly trabecular bones, and BMD of tibial diaphyses, which is a mainly cortical bone, (2) the breaking force and energy of femur. These results suggests the lobster shell powder could be a valuable source of dietary calcium in increasing BMD, breaking force and energy in osteoporotic model rats.


Enhanced phagocytosis of rat alveolar macrophages by intravenous infusion of an arginine-enriched solution.

Phagocytosis of rat alveolar macrophages (AM) was enhanced by the infusion of arginine-rich solution for 7 days. The enhancement of phagocytosis by arginine-rich solution was due to not the difference in the distribution of AM subpopulations (I to IV) but the difference in phagocytic activity of AM in fraction IV. In the process of phagocytosis, there were no significant differences in the stages of migration, attachment, and digestion between control and arginine-rich solutions, although AM from fraction IV of rats infused with arginine-rich solution showed significantly higher ingestion of opsonized sheep red blood cells (SRBC) compared to that of control group. Furthermore, the production of macrophage-activating factor (MAF) from rat splenocytes was higher in arginine-rich group than that of control group. AM from fraction IV of rats fed a stock diet had a higher arginase activity and showed a significant increase of phagocytosis following in vitro incubation with L-arginine (25 and 50 mM) for 24 h. From these results, the enhanced phagocytosis of AM by arginine-rich solution may be due to the increased phagocytosis of AM from fraction IV, in which the higher sensitivity of AM from fraction IV to arginine and the higher production of MAF from splenocytes following the infusion of arginine-rich solution participate.


Role of active oxygen species in the toxic effects of glucosone on mammalian cells.

Glucosone (D-arabino-hexos-2-ulose), a typical enediol product formed both in the Maillard reaction and gamma-radiolysis of sugars, decreased survival of Chinese hamster lung V79 cells, which were incubated under MEM for 4 h. Inhibition of the decrease in cell survival by catalase and SOD suggests the role of active oxygen species, namely H2O2 and O2-, in the biological effects of glucosone. H2O2 was formed in the medium during oxidative degradation of glucosone. Inhibition of the formation of H2O2 by SOD indicates that the formation of H2O2 and the consequent decrease of the cell survival was enhanced by O2-. These results suggest that the mechanisms of the effects of glucosone on the mammalian cells in the absence of Cu2+ are different from those in the presence of Cu2+.


Intake of iodine and major nutrients in an area of endemic goitre.

We surveyed the diet of a group of inhabitants in a mountainous area where goitre was endemic. The amount of iodine supplied by the diet was determined by analyzing foods with gas chromatography with electron-capture detection. The mean daily intake of iodine per person was between 286.4 and 1,134.4 micrograms. These values are within acceptable ranges recommended by several authors. The dietary supplies of proteins, fats and carbohydrates were also all within the ranges recommended by the FAO/WHO. Although goitre was endemic in the area studied, no dietary deficiency in iodine supply was found in any of the families investigated. Thus the ultimate cause of the endemic will have to be sought in other etiologic factors.


Effect of dietary chitin on cholesterol absorption and metabolism in rats.

The effect of chitin at the level of 5% in the diet on cholesterol absorption and metabolism was studied in Wistar rats fed on diet containing beef tallow (7%) and cholesterol (1%). When compared with pair-fed controls, rats fed on diet containing chitin had: (1) similar weight gain and feed efficiency, (2) lower apparent protein digestibility, (3) equivalent liver steatosis, (4) reduced levels of liver triglycerides and cholesterol, (5) similar levels of serum and fecal cholesterol, (6) higher excretion of triglycerides in feces.


The effect of dietary safflower phospholipid on steroids in gastrointestinal tract of rats fed a hypercholesterolemic diet.

The effect of dietary safflower phospholipid (Saf-PL) on the postprandial changes of steroids in the small intestinal and cecal contents was examined in rats fed a hypercholesterolemic diet. The triglyceride mixture (SP-Oil) containing a comparable amount of linoleic acid to Saf-PL was used as a reference fat source. Saf-PL suppressed the elevation of plasma cholesterol levels at all times after meal intake, when compared to SP-Oil. The reduction of plasma cholesterol in rats fed the Saf-PL diet was exclusively observed both in chylomicron plus very low density lipoprotein (VLDL) and low density lipoprotein (LDL) fractions. The rate of gastric emptying was not modified by the Saf-PL diet. The level of neutral steroids in the small intestinal contents was almost comparable in both groups, but in the cecal contents and feces it was significantly higher in rats fed the Saf-PL diet. On the other hand, the level of acidic steroids in the small intestinal contents tended to be higher in rats fed the Saf-PL diet than in those fed the SP-Oil diet, whereas in the cecal contents and feces it was comparable in the two diets. These results suggest that Saf-PL causes the accumulation of neutral steroids in the cecum due to the rapid transit through the small intestine.


Cultural variations in premorbid personality of endogenous depression: a transcultural study.

The triplet Typus Melancholicus proposed by Tellenbach (1961), endogenous depression, a good response to antidepressants, seems to give a form of clearly defined entity. In this study comparing Typus Melancholicus in Japan and in France, we have tried to differentiate the essential elements which vary according to culture. Thirty-eight patients corresponding to major depression (DSM-III-R) hospitalized in our clinics in Japan and in France and their families have been questioned during and after the pathological episodes using a method of our own devising. In Japan, Typus Melancholicus is generally respected and socially well integrated because of its first characteristic, or "orderliness with consideration to others." For that reason in the premorbid life, it is usually free from manifest conflict, and its personality is remarkably homogeneous. In France the opposite is true with the range of variations being wide with a high frequency of neurotic aspects. This may be due to the malfunction of "the orderliness with consideration to others" in France, where individualism is dominant. We have found two general types of variants, named "hypercommon" and "hypernormative." These two directions correspond to the elements that compose Typus Melancholicus: patients of the first group have a tendency to adapt to other's point of view; patients of the second group have a tendency to be under the pressure of a sense of obligation toward norms.


Some nosological considerations on "borderline case".

The so-called "borderline cases" are classified nowadays into Borderline Personality Disorder (BPD) or Schizotypal Personality Disorder (SPD) according to DSM-III-R. We discussed them as follows: The common pathology to them is their imaginary relationship to the object of identification. The difference between them is the distance from patients to their object. After presenting a case who is situated midway between the borderline case and neurosis, the pathology of borderline case can be described as a failure of repression. After classifying borderline cases in Japan into hysterical borderline or obsessional borderline, their relationship to hysterical neurosis and to obsessional neurosis are respectively discussed.


Social integration and suicide/homicide in Japan and the United States.

In Japan, economic factors were associated with the regional variations in suicide rates, unlike the United States where domestic factors (divorces and births) were associated with the regional variations in suicide rates. Homicide rates also had different social correlates in the two nations, indicating the importance of cross-cultural studies for the identification of reliable phenomena.


Bulimia nervosa in a pair of male monozygotic twins.

This is a report of a pair of male monozygotic twins meeting the DSM-III-R criteria for bulimia nervosa. At the age of 15, both brothers began to diet and suffered from bulimia. They were admitted to psychiatric hospitals and separated. After admission, their clinical course dramatically changed. The differences in their clinical courses and endocrinological data are suggestive as to the roles of environmental and hereditary factors in the etiology of bulimia nervosa.


Eating disorder and schizophrenia.

Five cases with eating disorders (one case with anorexia nervosa alone, 4 cases with anorexia nervosa and bulimia nervosa) complicated with schizophrenia and 3 cases of bulimia nervosa complicated with schizophrenia were reported. The eating disorders and schizophrenia were diagnosed according to the diagnostic criteria of DSM-III-R. As to the type of schizophrenia, 4 patients were of an undifferentiated type and 4 cases were of a disorganized type. Regarding the prepsychotic personality, 6 of the 8 cases showed schizothyme personality traits. All the patients showed depressive symptoms which are relatively common in eating disorders. In all the patients, significant social or school life difficulties persisted and a resumption of premorbid functioning was not seen. The possibility of an affinity between anorexia nervosa and schizophrenia was discussed.


Pseudodementia and delirium in depression: a contribution to psychosomatic medicine.

Presenting cases of depressional pseudodementia and delirium, we wish to point out the following points in this report. The patient in depression displays a state of pseudodementia when he is regarded as having senile dementia by the people around him. The depressed patient falls into delirium when he is embarrassed by an unexpected situation. In other words, the patient shows pseudodementia when he is continuously out of the world of daily meaning; he would fall into a disturbance of consciousness when he is suddenly put out of the world of meanings. This principle is applicable not only to depression but also to all mental diseases. In mental diseases, the symptoms themselves have some meaning for the patient. However, when the patient is put out of the world of ordinary meaning, mental disease presents the aspect of a somatic disease such as dementia or disturbance of consciousness.


Influences of prolonged bed rest and cognitive impairment on nursing home residents.

Seventy nursing home residents with and 87 without cerebrovascular diseases (CVD) were examined by the modified Stockton Geriatric Rating Scale (modified SGRS) which measures four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. They were divided into 3 subgroups according to walking ability; prolonged bed rest, walking with aids and walking by themselves in both groups. Physical disability of mental decline was significantly aggravated more than that of normal intelligence in all the subgroups. Although communication failure and apathy of mental decline had deteriorated more than those of normal intelligence in prolonged bed rest in residents without CVD, apathy of the former had deteriorated more than that of the latter in walking by themselves in residents with CVD.


An epidemiological study on hyponatremia in psychiatric patients in mental hospitals in Nara Prefecture.

Hyponatremia occurs often in mental illness. The frequency was not noticed because of the uncharacteristic symptoms of mild hyponatremia. Of the 1,114 psychiatric inpatients retrospectively surveyed, 10.5% had hyponatremia. Not only patients with schizophrenia, but also patients with other mental illness, especially with epilepsy, having hyponatremia were confirmed. An early onset, a long duration of psychiatric disorder and a prolonged admission were statistically significant factors. Nicotine abuse was not a significant factor. It was suggested that the pathogenesis of hyponatremia in psychiatric patients might be involved in a chronic course of psychiatric disorders and poor response to psychopharmacotherapy.


Accelerated plethysmogram in nursing home residents.

To investigate the peripheral blood circulation, 24 young volunteers, 28 nursing home residents with cerebrovascular diseases (CVD) and 42 residents without them were studied for accelerated plethysmogram (APG). Both residents were rated by the modified Stockton geriatric rating scale (modified SGRS) which have four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. As to the waveform patterns of APG, the majority of the young volunteers and both the residents showed patterns B and G, respectively. Coefficient of APG (Co-APG) of the former was significantly larger than that of the latter. In the residents without CVD, Co-APG was significantly negatively correlated with physical disability and apathy of the modified SGRS. But, Co-APG did not correlate with the modified SGRS in the residents with CVD.


Changes in personality and emotion following bilateral infarction of the posterior cerebral arteries.

Remarkable changes in personality, emotion and behavior were observed in a 66-year-old female with bilateral infarction of the medial inferior portion at the temporo-occipital region. Aggressiveness, emotional lability and indifference were noted in the patient as psychiatric manifestation. No definite delirium, however, was observed. A neuroradiological examination revealed the lesions located at the territory of the posterior cerebral artery, which involved the hippocampus, the parahippocampal gyri, the fusiform gyri and the lingual gyri. Therefore, the psychiatric disturbances and the neuropsychological symptoms presented here are attributed to these lesions with the multiple infarctions in the brain. The present case is noteworthy for its unique changes in personality and emotion which in the literature have not reported to be caused following the vascular accident of the bilateral posterior cerebral artery.


Comparison of thyroid function between responders and nonresponders to thyroid hormone supplementation in depression.

The serum levels of thyroxine (T4), 3,5,3'-triiodothyronine (T3) and 3,3',5'-triiodothyronine (reverse T3, rT3) were examined from 8 depressed patients who did not maximally benefit from conventional antidepressant therapy. Four of the 8 depressed patients showed significant clinical improvement after thyroid hormone was added to their ongoing antidepressant drugs. The T4 and rT3 levels prior to thyroid hormone supplementation were significantly lower in responders than in nonresponders, although within the normal range. Furthermore, all of the patients who had both their rT3 levels less than 200 pg/ml and T4 levels less than 7 micrograms/dl responded to the thyroid hormone treatment. These data suggest that the lower T4 and rT3 levels can predict the treatment response to the thyroid hormone supplementation in depressed patients.


A retrospective study on delirium type.

The clinical features of delirium type were retrospectively studied to characterize a delirium type in consecutive 106 patients. The subjects suffered from 15 medical diseases and were grouped into hyperactive, hypoactive and mixed types according to their cardinal features. The incidence of delirium was the highest in 70-year-old subjects and there was a gender effect in all the subjects. A decade effect was present in the outcome, delirium type and delirium duration. The delirium type was associated with age at the delirium onset, outcome and underlying disease. The incidence of hypoactive type correlated with that of mixed and hyperactive types, and a high rate of full recovery in the hyperactive type and a high rate of death in the mixed type were noted. The increase in incidence of the mixed type and the decrease in incidence of the hyperactive type contributed to a poor outcome. Malignancy, hepatic, cerebrovascular and bone and joint diseases highly correlated with the occurrence of delirium.


Shortening of N1 and P3 latencies in event-related potentials observed coincidentally with clinical improvement during nootropic medication in a demented patient: specific effect of nicergoline.

Event-related potentials, measured eight times in a patient in the early stages of dementia, demonstrated that clinical symptoms, especially loss of motivation, improved coincidentally with a shortening of reaction time, N1 latency, and P3 latency during nicergoline medication among three nootropics prescribed. Such a longitudinal study design was considered to be useful for quantifying and objectively comparing effects of various nootropics noninvasively.


Decreased superoxide dismutase activity in erythrocyte in Parkinson's disease.

Superoxide dismutase (SOD) activities in Parkinson's disease (PD) were significantly lower than those in controls, especially in a treated PD group. However, SOD activities in an untreated PD group did not decrease. There was a significant correlation between SOD activities and the duration of illness in the treated PD group (p < 0.05). There was a significant correlation between SOD activities and the present doses of L-DOPA/carbidopa in the treated PD group.


Validity of electrode placement at Fpz to detect alpha wave.

The possibility on placing electrodes at Fpz-A2 instead of C3-A2 was investigated to obtain a more stable configuration avoiding obstruction by the hair. Our original system of alpha wave detection by a microcomputer was used, and a total of 22 all-night hypnograms of five healthy young students was recorded. Pearson's moment correlation coefficients of alpha wave % between the two positions were 0.780-0.948. Except for one subject, alpha wave % taken at Fpz-A2 tended to be 3-5% lower than that at C3-A2. The above analysis indicates that using EEG electrode position of Fpz-A2 is valid and useful as a stable electrode configuration for a long-time monitoring.


Circadian variation in R-THBP-induced enhancement of the ambulation-increasing effect of methamphetamine on mice.

6R-L-erythro-5,6,7,8-tetrahydrobiopterin (R-THBP), a co-factor for tyrosine hydroxylase and tryptophan hydroxylase, induces the enhancement of ambulation-increasing effect of methamphetamine on mice. In this study, we investigated the circadian variation in the interaction between R-THBP and methamphetamine by changing the time-of-day of both methamphetamine administration and pretreatment with R-THBP. The mouse's ambulatory activity was measured by a tilting-type activity cage for 4 hr. In the daytime, but not in the nighttime, the ambulation-increasing effect of methamphetamine (1 and 2 mg/kg, s.c.) was significantly enhanced by the pretreatment with R-THBP (100 mg/kg, s.c., 2 or 6 hr before). These data indicate the possibility that peripherally administered R-THBP increases the biosynthesis of catecholamine especially in the daytime.


Synaptosomal membrane fluidity, lipid peroxidation and superoxide dismutase activity in the brain of amygdala-kindled rats.

Synaptosomal membrane fluidity, lipid peroxide (LPO) and cytosolic superoxide dismutase (SOD) activity were examined in various brain regions (amygdala, hippocampus, striatum and frontal cortex) of amygdala-kindled rats. At 24 h after the last seizure, a significant increase of membrane fluidity was observed in all the regions examined, whereas the LPO level was significantly decreased in the four regions with enhanced activity of cytosolic SOD. At 7 days after the last seizure, membrane fluidity was decreased only in the hippocampus. At 6 weeks after the last seizure, there were no changes in membrane fluidity between control and kindled rats. These results suggest that membrane fluidity and lipid peroxidation are modulated transiently by a kindled seizure, but not at a steady state of kindling with enduring seizure susceptibility.


Lack of effect of haloperidol or methamphetamine treatment on the mRNA levels of two dopamine D2 receptor isoforms in rat brain.

In order to investigate whether changes of the two mRNAs encoding the D2 receptor isoforms were induced by chronic haloperidol or methamphetamine treatment in rats, we measured the brain mRNA levels using in situ hybridization histochemistry (ISHH). We used two oligonucleotide probes, an "insert" probe to hybridize with the longer D2 receptor, D2(444), mRNA, and a "spanning" probe to hybridize with the shorter D2 receptor, D2(415), mRNA. Both D2 mRNAs were detected by ISHH in the caudate putamen, nucleus accumbens, substantia nigra, pars compacta and ventral tegmental area. The distributions and the amounts of the mRNAs for the two D2 isoforms did not change after chronic administration of haloperidol (1 mg/kg/day for 14 days, ip) or methamphetamine (4 mg/kg/day for 14 days, ip). These results suggest that the changes of D2 receptor density induced by chronic neuroleptic and psychostimulant treatment are not due primarily to receptor expression.


Use of dengue blot in dengue diagnosis: the Malaysian experience.

Dengue fever/Dengue haemorrhagic fever (DF/DHF) has been a public health problem in Malaysia with an endemic level of about 7 per 100,000 population per year. In 1990, Malaysia experienced its most severe outbreak of DF/DHF with a record total of 5,590 cases referred to the Division of Virology, Institute for Medical Research (IMR). Of these, 1,880 were confirmed serologically to be DF/DHF. The conventional serological procedure, the Haemagglutination Inhibition (HI) test, for the diagnosis of DF/DHF is cumbersome and causes delay in diagnosis. Another problem associated with the HI test has been that it has often been difficult to obtain a second convalescent serum sample for an accurate diagnosis. This has raised an urgent need to establish a "rapid" test for diagnosis of DF/DHF. As such the authors recently carried out an evaluation of a newly available commercial rapid test, namely, the Dengue Blot Assay (Diagnostic Biotechnology Singapore Pte Ltd). The test is intended for use in laboratory confirmation of dengue virus infection. The evaluation was to determine if the test could be utilised as a routine laboratory test and to establish its sensitivity and specificity. Over 400 samples were tested against the Dengue Blot Assay. Results were checked against an in-house Dengue IgM ELISA and HI assay. Preliminary results indicate that the sensitivity and specificity of the Dengue Blot is satisfactory. Our results also indicate that the Dengue Blot has a useful role to play in a routine laboratory especially since it provides rapid results on single serum samples thereby reducing the workload in a busy diagnostic laboratory.


Antibody deficiency with hyper IgM--a case report.

A 20-month-old Indian boy presented with recurrent pyogenic infections and failure to thrive. His IgG and IgA levels were low, but his IgM was elevated. He also had undetectable isohaemagglutinin titre and neutropenia, both parameters being poor prognostic indicators in this very rare primary immunodeficiency state--antibody deficiency with hyper IgM. Our patient subsequently succumbed to Pseudomonas aeruginosa septicaemia and meningitis inspite of aggressive antibiotic and intravenous gammaglobulin therapy. To the best of our knowledge, this is the first such case to be documented in Malaysia.


In situ hybridisation: principles and applications.

In situ hybridisation (ISH) is based on the complementary pairing of labelled DNA or RNA probes with normal or abnormal nucleic acid sequences in intact chromosomes, cells or tissue sections. Compared with other molecular biology techniques applicable to anatomical pathology, ISH enjoys better rapport with histopathologists because of its similarity to immunohistochemistry. It has the unique advantage over other molecular biology techniques--largely based on probe hybridisation with nucleic acid extracted from homogenised tissue samples--of allowing localisation and visualisation of target nucleic acid sequences within morphologically identifiable cells or cellular structures. Probes for ISH may bear radioactive or non-radioactive labels. Isotopic probes (3H, 32P, 35S, 125I) are generally more sensitive than non-isotopic ones but are less stable, require longer processing times and stringent disposal methods. Numerous non-isotopic labels have been used; of these biotin and digoxigenin are the reporters of choice. Optimised non-isotopic systems of equivalent sensitivity to those which use radioactive-labelled probes have been described. In ISH, finding the optimal balance between good morphological preservation of cells and strong hybridisation signals is crucial. Tissue fixation and retention of cytoskeletal structures, unfortunately, impede diffusion of probes into tissues. ISH sensitivity is also influenced by inherent properties of the probe and hybridisation conditions. Although ISH is largely a research tool, it is already making strong inroads into diagnostic histopathology. It has been applied for the detection of various infective agents particularly CMV, HPV, HIV, JC virus, B19 parvovirus, HSV-1, EBV, HBV, hepatitis delta virus, Chlamydia trachomatis, salmonella and mycoplasma in tissue sections.(ABSTRACT TRUNCATED AT 250 WORDS)


Drowning.

A body recovered from the water does not necessarily imply that death was due to drowning. The diagnosis of drowning is discussed together with the significance of the "diatom" and biochemical tests.


Immunostaining of formalin-fixed, paraffin-embedded tissues for malignant lymphomas.

With the advent of new monoclonal antibodies that are applicable to formalin-fixed, paraffin embedded sections, immunophenotyping is becoming increasingly important in the diagnosis and classification of lymphomas. However, multiple factors such as fixation, trypsinization and even type of antibodies used have certain effects on the final outcome of the staining procedure. In this paper we report our experience and the problems encountered in our laboratory when we first tried to establish a workable immunostaining protocol for formalin-fixed, paraffin embedded tissue sections using the immunoalkaline phosphatase technique.


Alpha-1-antitrypsin deficiency in babies with prolonged jaundice.

Over a three-year-period, 310 babies with prolonged jaundice admitted to GHKL were studied, to determine the incidence of alpha-1-antitrypsin deficiency as a cause of the problem. Ninety-two babies (29.7%) were found to be alpha-1-antitrypsin deficient. The percentage incidence was found to be highest in Indians (33.3%), followed by Malays (31.9%) and Chinese (26.7%). There was a male preponderance with a M:F ratio of 1.6:1. Most of these babies presented at the hospital at the age of more than two weeks but less than one month. Apart from the problem of prolonged jaundice and alpha-1-antitrypsin deficiency, 2 had associated bleeding problems, 11 associated infections and 3 respiratory problems. Two babies had clinical features of Down's syndrome, 2 had G6PD deficiency and 1 had congenital hypothyroidism. AST, ALT and ALPO4 were high in 20, 26 and 3 babies respectively.


Antimicrobial resistance: patterns and trends in the National University Hospital, Singapore (1989-1991).

The commonly isolated organisms, Staphylococcus aureus, Escherichia coli, Klebsiella species, Pseudomonas aeruginosa, Acinetobacter species, Proteus species and Enterobacter species from clinical material other than blood, cerebrospinal fluid and stool, were analysed for their incidence and increasing trends of resistance to the commonly used antimicrobials. Staphylococcus aureus was tested against penicillin, methicillin, erythromycin, gentamicin and co-trimoxazole; Pseudomonas aeruginosa against amikacin, ceftazidime, gentamicin, piperacillin and cefsulodin; and gram negative bacilli against ampicillin, co-trimoxazole, cephalexin, cefuroxime, ceftriaxone, nalidixic acid and nitrofurantoin. Methicillin sensitive Staphylococcus aureus exhibited a high degree of resistance to penicillin only (83%), but methicillin resistant Staphylococcus aureus (34-46%) showed nearly 100% resistance to all drugs tested except for co-trimoxazole over the period of study. A high incidence of resistance was found among Klebsiella species, Enterobacter species, Acinetobacter species and Pseudomonas species. Increasing trends of resistance against cephalosporins were noticed with respect to Acinetobacter species, Klebsiella species and Enterobacter species for cefuroxime and ceftriaxone; Pseudomonas aeruginosa for ceftazidime and cefsulodin. The overall resistance of organisms is notably high. Methicillin-resistant S. aureus is endemic and accounts for about 39% of all S. aureus isolates. The typical nosocomial organisms like Acinetobacter species and Klebsiella species are increasingly developing resistance to useful drugs such as gentamicin, cephalexin and ceftriaxone.


[Radio-cinematographic study of active elevation of the prosthetic shoulder].

In order to verify whether it is possible to reproduce the physiologic anterior elevation of the shoulder with a non constrained Neer type prosthesis, the authors have examined the dynamic comportement of 21 total shoulder arthroplasties. Recording of anterior active elevation with video-fluoroscopy and evaluation glenohumeral motion and scapulothoracic motion allowed to distinguish 3 types of biomechanics after total shoulder replacement. A first group of prosthesis (4 cases) had normal biomechanics with conservation of a normal scapulohumeral rythm. This concerned arthroplasties performed for necrosis or osteoarthritis with no cuff tear or loose bone stock and no technical error. A second group of prosthesis (10 cases) had an abnormal biomechanics. There was a superior excursion of the humeral head prosthesis without real glenohumeral motion. A more severe pathology (cuff tear arthropathy, rheumatoid arthritis, old traumas) with bone and/or muscular destruction was sufficient to explain this elevation possible only because of the scapulothoracic motion. Finally, there was a third group of prosthesis (7 cases) which had a reversed scapulohumeral rythm: there was less motion between the prosthetic components but the scapulothoracic motion was unchanged. Three factors can be responsible for this reversed scapulohumeral rythm: 1) The initial pathology, because of the difference in the cuff trophicity. 2) The surgical technic because of the difficulties to respect the position of the joint line and the lever arms. 3) The prosthesis itself, because of the higher degree of conformity and stability between the prosthetic components.


[Prevention of scar formation by polyglactin 910 (Vicryl) mesh after lumbar laminectomy in the rat].

Laminectomy in lumbar spine surgery often produces disabling adhesive arachnoiditis. We have tested, on the rat, polyglactin 910 mesh with collagen or not, with a mail 0.9 mm large. We have used 34 Wistar male rats. L5 laminectomy were realised on all the rats. Rats were ranged in four groups: group 1: control, L5 laminectomy alone, 6 months follow up--group 2: one month follow up, L5 laminectomy, vicryl mesh with collagen or not--group 3: two months follow up, L5 laminectomy, vicryl mesh with collagen or not--group 4: six months follow up, L5 laminectomy, vicryl mesh with collagen or not. On 28 rats, the histologic study have demonstrated: group 1 control: important and adhesive fibrosis scar--group 2: no or minimal reaction--group 3: fibroblastic or few cellular, non or little adhesive fibrosis--group 4: moderate adhesive fibrosis in half of the cases with vicryl mesh without collagen, minimal non adhesive fibrosis with collagen vicryl mesh.


[Excision of the proximal row of the carpal bones. Apropos of 21 patients].

Twenty one patients have been reviewed with a mean follow-up of 4.6 years. If we except one acute case, the main indications were scaphoid pseudarthrosis (13 cases), Kienbock's disease (4 cases), carpal instability (3 cases) all accompanied by wrist arthrosis. The results were considered excellent and good in 65 per cent of the cases. Pain was improved in 90 per cent of the patients. Average mobility was 71 degrees (76 degrees before operation). Strength was improved in 19 per cent of cases but remained less than the normal side in 60 per cent. Among 15 manual workers 11 went back to the same work and 4 to an adjusted work.


[Surgical treatment of rotator cuff rupture. Prognostic factors].

A retrospective study of 67 total ruptures of the rotator cuff operated on was carried on, with an average follow-up of 25 months. The lesions were characterised by their size (19 tears of less than 2 cm, 30 between 2 and 4 cm, 18 over 4 cm) and location (27 tears of the supraspinatus, 15 tears of the supraspinatus extending to the front (coraco-humeral, long biceps, subscapular), 20 supra and infra-spinatus, 5 "massive" tears). The tendon of the long biceps was pathological in half of the cases. Fourteen patients presented with a subacromial osteoarthritis. All patients benefited from a decompression and repair of the rupture. Whereas the subjective results indicate 92 per cent satisfied patients, from the objective point of view the average score with Constant's rating was 62.5 pts with 53 per cent favorable results. Evaluation of force was a particular subject of attention: the results obtained with three charts were compared; the conclusion was in favour of an objective measurement using a dynamometer but with a weighting according to age and sex. The characteristics of the tear (location especially), the state of the long biceps, the presence of a subacromial osteoarthritis and the pre-operative mobility affected statistically and significantly the final result. The authors reserve reconstructive surgery for tears without osteoarthritis, isolated lesions of the supraspinatus having the best prognosis. The existence of a subacromial osteoarthritis, always a sign of a massive tear, in elderly patients should lead one to choose a procedure a minima under arthroscopy.


[Role of tibial-fibular grafting in the treatment of infected pseudarthrosis of the tibia].

The author presents a series of 112 patients, suffering an infected fracture or nonunion of the tibia, and operated on by intertibio-fibular grafting (ITFG), between 1960 to 1990. 110 of them were followed up during average 5 years. Some points of the technic are detailed. The whole treatment associates immobilization, antibiotherapy, cleaning procedures and eventually complementary grafting. All patients were consolidated, 73 after ITFG alone, 13 by association, in the same stage, of an open cancellous filling, following Papineau technique. 24 needed a complementary grafting, among them 7 because a technical flaw. 5 iterative fractures were observed, only one of them has not united. 96 patients were cured of any sepsis, most often by associated cleaning procedures, achieved either before or after ITFG. It existed 14 persistent draining sinus, but only 4 may be considered as real failures. The involvement of the ankle joint was unfortunately quite frequent, but it did not seem to be the consequence of the synostosis, but rather of the duration of immobilization. After review of the literature, the other methods of treatment were discussed, particularly these of Papineau and of Ilizarov. The conclusion was that each method has indications, but the ITFG must keep the largest place, being indicated in about two cases out of three.


[Grice subtalar arthrodesis: a long-term follow-up in poliomyelitis sequelae].

A retrospective review was done of 19 poliomyelitis feet on which the standard Grice subtalar arthrodesis was performed for correction of valgus feet deformity. The average time of follow-up was 12.1 years. Seventy-nine per cent of the feet had satisfactory results, and all the failures were due to technical errors of graft placement. The calcaneo-first-metatarsal angle on the standing lateral radiograph was found to be the most objective angle and correlated best with the clinical results. The long term effects on the rest of the foot was negligible, with only 3 of the 10 feet, with a follow-up longer than 12 years showing minimal talonavicular arthritis and only 1 ankle developing a ball and socket joint. Ankle valgus was not a significant problem.


[Treatment of subcutaneous ruptures of the Achilles tendon by percutaneous tenorraphy].

Since 1982, the authors have progressively settled a technique to repair the calcaneal tendon, the result of which is a percutaneous tenorraphy exclusively used for more than 2 years. Their study includes 28 cases between 1989 and 1992, with an average post operative time of 15.6 months. The technique is fully described, its aim was to restore a normal length of the ruptured tendon in placing together the 2 tendinous ends during the required time to obtain natural regeneration of the Achilles tendon. It reduces the theoric immobilization time, makes rehabilitation easier as well as the return to sportive and professional activities. The suture was percutaneously made with a special material: A Dacron yarn with a 5 mm wide hook set on a 12 long flexible needle. The results were globally good and only very few complications were observed.


[Bilateral Kienbock's disease in adolescents. Apropos of a surgically treated case].

The authors report a case of bilateral idiopathic stage III Kienböck's disease. Treatment was surgical and consisted in a shortening osteotomy of the radius, with excellent clinical results. X-rays showed that osteonecrosis was stopped and both lunate bones were gradually remodelled.


[Unilateral tibia vara in young children caused by focal fibrocartilaginous dysplasia. Apropos of 4 new cases].

The authors report 4 cases of tibia vara associated with focal fibrocartilaginous dysplasia observed in 3 boys and 1 girl between the ages of 11 and 17 months. Deformation was usually discovered when the child began to walk. It can worsen during the first years of life, thus explaining that two subjects were operated at 3 years and at 4 years and 8 months, with osteotomy for valgus rotation. The outcome was good. The other 2 recovered spontaneously. The authors discuss the diagnostic and pathophysiological problems in the light of the data in the literature and confirm that correction is usually spontaneous, which justifies refraining from treatment.


[Reliability and reproducibility of 3 peak flowmeters determined in a population of primary school children].

Peak-flow measurement increasingly seems to be very useful for routine monitoring of asthma in children. The purpose of this study was to evaluate the reliability and reproductibility of three different peak-flow meters: Miniwright, Vitalograph and Assess. This prospective study was conducted in 100 primary school children aged from 6 to 11 years. In each child, 9 measurements of expiratory peak-flow rate (EPF) were performed with these 3 peak flow meters in a random order. Reproductibility was assessed for each instrument by the greatest divergence observed between the 3 EPF values measured in the same session. Reliability was assessed by comparison between the values obtained with each instrument and theoretical EPF values calculated from a formula which included age, sex and size. Our study validated the reliability and reproductibility of the 3 peak flow meters studied. EPF values were more scattered and less reproductible with Assess, but the difference was not significant.


[Perceptions of consequences of chronic respiratory insufficiency in subjects over 65 years with home respiratory assistance. Apropos of 85 patients].

Chronic respiratory diseases (C.R.D.) induce changes in daily activities and mood for the patients who require respiratory assistance (oxygen delivery or ventilation). The aim of this study was to compare physical and social consequences of this disease. A self administered questionnaire was sent to one hundred patients, over sixty five years of age, who were affiliated with the "Association Limousine d'Aide aux Insuffisants Respiratories" (A.L.A.I.R.). The mean age was 72.4 +/- 0.66 (65-92), the mean PaO2 was 54 mm Hg +/- 0.2 (39-76). C.R.D. was stable during the study and treatments did not change. The questionnaire was composed of four scales and twenty-eight subjects; each item was weighed for importance. Subjects included: symptoms, mood, sleep, relationships with their wife or family, home activities. Eighty-five questionnaires were analysed. Reproductibility was good (92%) and non-responses to some questions was less than 10%. Coherence between the scales and the twenty-eight items was poor. Regression linear analysis found that only dyspnea was correlated with PaO2 (p < 0.007). For patients, the most important items were: abnormalities of home activities (37%), dyspnea (38%), relationships with their wife (39%) or family (45%), dependence (52%) and perception of A.L.A.I.R. (77%). Quality of life is an important concept for these patients with C.R.D. versus clinical symptoms. Perception of respiratory assistance is very good.


[Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice].

One hundred and eighty eight outpatients with community acquired pneumonia have been treated by spiramycin in general practice. Community acquired pneumonia was defined by the association of fever > or = 38 degrees C, respiratory symptoms as cough, sputum production, dyspnea or thoracic pain, and pulmonary opacity on the chest X-Ray. The mean age of patients was 44.7 +/- 16.6 and few of them had concomitant chronic illness, as cardiovascular (9%) or bronchopulmonary disease (9%). Twenty one percent of patients have been included after a previous antibiotherapy failure. In 92% on these cases, prior antibiotherapy was a beta lactam. At inclusion, the fever was greater than 39 degrees C in 56% of patients, 58% had localized crepitations at the chest auscultation. The chest X-Ray was performed 1.4 +/- 2.1 days after inclusion and showed a lobar consolidation in 77%. One third of patients presented a clinical picture evoking acute bacterial pneumonia. One hundred and seventy one patients have been reviewed for a second evaluation 4 +/- 1.5 days after inclusion. One hundred and eighty seven patients have visited for the long term follow up 19 +/- 6.5 days after the onset of treatment. Ninety six per cent of them have consulted with a control chest X-ray. At this visit, the antibiotherapy was changed in 2 other patients with of failure. Overall, 83% of patients were clinically and radiologically cured by Spiramycin 3 MU twice a day for 13 +/- 3.5 days. Fourteen percent of patients were improved without necessity of changing the antibiotic regimen. This study confirms the efficacy of spiramycin in the management of community acquired pneumoniae in general practice, either in first line therapy of after the failure of beta lactam.


[Loeffer's syndrome: is Taenia responsible?].

Taenia saginata is a parasite of the gastrointestinal tract which is often encountered in France. Its responsibility in the occurrence of pulmonary eosinophilic infiltrates is only exceptionally suspected. We report a case of Loeffler's syndrome most probably caused by Taenia saginata. This case illustrates the diagnostic problems encountered to determine the responsibility of this cestode.


Anatomical study of preaxial polydactyly in 158 hands.

Preaxial polydactyly is a common congenital hand anomaly. Here in 138 patients with 158 duplicated thumbs, a new classification of this anomaly was done from analysis of radiographs and operation records. Initially all the duplicated thumbs were arranged into from Type I to VII on the basis of radiological extent of bifurcation. Appendage type was noted as a separate entity. Type IV was found the most common and had 53 thumbs (33.6%) involved. But findings on surgery indicated that the exact level of bifurcation varied in each type, and Type VII became three times as frequent as previously noted from x-ray examination at the time of surgery. Radiologically encountered duplications at IP (Type II), MP (Type IV) and CM (Type VI) joints were specifically classified into five groups from A to E on the basis of the structural changes detected on surgery. Details in each group were discussed.


Characterization of human thymic lymphocytes forming rosettes with stromal cells.

The interaction of thymic lymphocytes and stromal cells is believed to be important for T cell development in thymus. In this study, thymic rosettes (TR), which are cell-cell complexes of thymic lymphocytes and stromal cells, were isolated from human thymic tissue, and were characterized. Treating human thymus with collagenase in mild condition, human TR were successfully isolated. Subsequently, TR were purified by the 1G sedimentation method. Human TR consisted of a stromal cell in center surrounded by lymphocytes. The stromal cells were positive for CD14, CD11b, and HLA-DR but negative for thymic epithelial cell specific mAb, UH-1, suggesting that they are macrophage/dendritic cells. The lymphocytes which formed TR (TRL) were mainly double positive (CD4+CD8+) and CD1+ cells, and few of them expressed bright CD3, indicating that TRL are in the intermediate maturation stage. TRL expressed activation markers (Ta1 and HLA-DR) in a significantly higher percentage of cells than did unselected thymocytes. Blocking test revealed that CD11a and CD2 are involved in the binding of TRL and the stromal cells as adhesion molecules.


Anesthetic influences on myocardial and hepatic energy metabolism in hemorrhaged spontaneous hypertensive rats.

Twenty four spontaneously hypertensive rats (SHRs) were used to assess the influence of anesthetics on myocardial and hepatic energy metabolism after hemorrhage. They were divided into four groups: a control group and three others which received pentobarbital (60 mg.kg-1 ip), 2.2% enflurane, or 1.4% isoflurane. Following a 10-min stabilisation period, blood (2 ml.100 g body weight-1) was gradually withdrawn over a 5-min period from a femoral artery. Thirty minutes after the induction of hemorrhage, the heart and liver were removed, and myocardial and hepatic metabolites (ATP, lactate, pyruvate, and glycogen) were measured by the enzymatic methods. Metabolic acidosis and decreased hematocrit were noted in all groups after hemorrhage. The mean arterial pressure in rats receiving anesthetics decreased significantly in comparison with the control group. There were significant increases of myocardial and hepatic lactate/pyruvate ratios in rats receiving enflurane when compared with controls. These results suggest that enflurane may be more detrimental than other anesthetics to the maintenance of anesthesia in hypovolemic SHRs.


Polysaccharide-coated liposomal amphotericin B for the treatment of murine pulmonary candidiasis.

Amylopectin-coated liposomal amphotericin B was investigated in a murine model of pulmonary candidiasis. The LD50 of amylopectin-coated liposomal amphotericin B in normal mice was more than 10.0 mg/kg, and that of conventional amphotericin B was 1.2 mg/kg. Amylopectin-coated liposomes showed twice the concentration in the lungs of conventional liposomes. Candida albicans was inoculated intratracheally into BALB/C mice. Twenty-four hours later, the number of Candida in the lungs of mice treated with amylopectin-coated liposomes was less than in those treated with conventional liposomes, and amylopectin-coated liposomes improved the survival rate of inoculated mice. Coating liposomes with amylopectin aids the targeting of amphotericin B to the lungs.


Synovial fluid ferritin in traumatic hemarthrosis, rheumatoid arthritis and osteoarthritis.

Synovial fluid ferritin levels in patients with traumatic hemarthrosis (HA), rheumatoid arthritis (RA), and osteoarthritis (OA) were measured by double antibody radioimmunoassay. Synovial fluid ferritin levels were significantly higher in 60 patients with HA (mean +/- S.D., 536 +/- 536 ng/ml) and 39 patients with RA (614 +/- 486 ng/ml) than in 20 patients with OA (130 +/- 119 ng/ml) (p < 0.01). Individual levels, however, considerably varied. In HA patients, the synovial fluid ferritin level correlated well with the duration of hemarthrosis, but not with hemoglobin, hematocrit, or an inflammatory synovial fluid index such as the leukocyte count. In RA patients, there was no significant correlation between the synovial fluid ferritin levels and any inflammatory parameter, such as catalase activity, synovial leukocyte counts (including polymorphs and monocytes) or the duration of arthritis. Our results indicate that the synovial fluid ferritin level reflects primarily hemoglobin degradation and appears unrelated to inflammation in joint diseases.


An improved method of bronchial stump closure for prevention of bronchopleural fistula in pulmonary resection.

We performed 880 pulmonary resections from January 1982 to June 1988 using Sweet's procedure for closure of the bronchial stump, in which 39 patients (4.4%) developed bronchial fistulas. Bronchoscopic studies showed that bronchopleural fistulas were located mainly at the corner of the stump. This indicates that the corner is the point with the highest tension when Sweet's procedure is employed. In some cases, stumps were injured by suture materials, resulting in bronchopleural fistulas. Since July 1988, bronchial stumps have been closed by using two pairs of teflon pledgets with additional interrupted sutures. From July 1988 to April 1990, 288 patients were treated by this new method, and only one of them developed bronchopleural fistula. This new method prevents injury of the stump by suture material and reduces the tension at the bronchial stump for a long time. Thus, pulmonary resections can be safely employed even after anti-cancer chemotherapy and/or radiation therapy.


Effects of an anthelmintic treatment programme on sheep productivity in the Middle Atlas, Morocco.

This study evaluated the production advantages of the strategic anthelmintic treatment of both lambs and ewes in an area endemic for gastro-intestinal nematodes, lungworms and liver flukes. The liver fluke infections were generally chronic. The lambs were treated with albendazole (SmithKline Beecham), fenbendazole (Hoechst Roussel) or a vitamin supplement and their weight gains were followed over the next 7 months. The control group, which received a vitamin supplement only, gained 6.67 kg from July to January. The group that received fenbendazole, an anthelmintic with no activity against liver flukes, gained 10.42 kg over the study period. The third group which received albendazole, an anthelmintic with efficacy against liver flukes, gained 13.07 kg over the same period. Lamb deaths apparently due to liver flukes were 12, 4, and zero for the control, fenbendazole and albendazole groups, respectively. Similar advantages were observed in the ewes. Deaths were 16, 8, and zero in the control, fenbendazole and albendazole groups, respectively. The lambing rate in the control group was significantly lower than that in either of the 2 treated groups. The number of services per conception was significantly lower in the albendazole treated group than that in either of the other groups. These studies demonstrated the advantages of anthelmintic treatment in sheep in a helminth endemic area. While removing gastro-intestinal nematodes and lungworms improved production, the additional removal of liver flukes enhanced production gains as well as reducing deaths.


Reproduction of pigs in the hills of eastern Nepal.

A survey of 101 farmers with sows was conducted in the Koshi Hills of Nepal. Estimates of those reproductive traits which did not differ significantly between local and Pakhribas crossbred sows, are farrowing interval 7.4 months, litter size at birth 8.3, age of piglets at weaning 2.2 months and total number of farrowings 13.2. Local pigs reach sexual maturity sooner than Pakhribas crossbreds; age at first farrowing for the two genotypes is 10.7 and 12.0 months (P < 0.05), and age at first mating of boars is 6.5 and 7.4 months (P < 0.05). Sows farrow throughout the year and there is no clearly defined best season for farrowing. Pre-weaning mortality rates are estimated to be 22% for local piglets and 15% for Pakhribas crossbreds. Almost all farmers practise controlled mating in which either the sow is taken to the boar or the boar is brought to the sow. The proportion of farmers (with sows) who own a boar is only about 5 per cent.


Productivity and health of camels (Camelus dromedarius) in Somalia: associations with trypanosomosis and brucellosis.

In Somalia, one of the world's largest dromedary populations of about 5.3 million animals are kept by nomadic pastoralists under traditional management. Interest in the development potential of camel herds in the semi-arid areas of central Somalia initiated an investigation to determine the productivity of herds, their major diseases and likely associations among these parameters. Using a systems approach, data were collected for herd production parameters, environmental factors, management and production systems, and health variables. One thousand and thirty nine camels in 33 herds were studied in the central regions of Somalia. Trypanosoma evansi prevalence ranged from 1.7% in blood-smears to 56.4% using enzyme-linked immunosorbent micro-assay (microELISA). Seroprevalence for brucellosis was determined as 1.9% by the standard agglutination test (SAT) and 0.3% by the complement fixation test (CFT). Using multiple regression, 15% of the total variation of the general fertility rate was explained by the results of the microhaematocrit centrifugation technique (MHCT) and the microELISA for T. evansi, CFT results for brucellosis, herdsize, and young stock death rate. Among herd production variables, herd size differed significantly for different management units. Young stock death rates, as well as general fertility rates varied in the ecological subzones with a marked effect in the zones labeled "Inland". Various other associations were noted among demographic, husbandry and disease variables. The importance of trypanosomosis and brucellosis to the productivity of herds and measures to control their limiting effects on production were discussed.


Therapeutic activity of isometamidium chloride in Boran cattle against a tsetse-transmitted clone of Trypanosoma congolense with a low level of drug resistance.

Experiments were conducted with a clone of Trypanosoma congolense, IL 3580, which exhibited a low level of resistance to isometamidium chloride. Five cattle were treated intramuscularly with isometamidium chloride at a dose rate of 0.5 mg kg-1 body weight (BW) and challenged 28 days later with 5 Glossina morsitans centralis infected with T. congolense IL 3580. All 5 cattle and 15 untreated steers challenged on the same day became parasitaemic by day 15 post-infection. Thus, at a dose of 0.5 mg kg-1 BW, the prophylactic action of isometamidium chloride did not extend to 28 days following treatment. Subsequently, the 20 steers were divided into 4 groups of 5 animals each and treated with isometamidium chloride at one of the following dose rates; 0.5 or 1.0 mg kg-1 BW intramuscularly and 0.5 or 1.0 mg kg-1 BW intravenously (Groups A, B, C and D, respectively). Group A consisted of the 5 animals that had previously been treated with isometamidium chloride. Animals relapsed in all groups except those in Group B, treated intramuscularly with isometamidium chloride at a dose of 1.0 mg kg-1 BW. Four of the 5 animals in Group A, treated intramuscularly with isometamidium chloride at a dose of 0.5 mg kg-1 BW relapsed following a mean interval of 16 days post-treatment. Similarly, infections in all animals in Groups C and D, given intravenous injections of isometamidium chloride at a dose of 0.5 and 1.0 mg kg-1 BW, respectively, were not eliminated as a result of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)