The effect of paroxetine on anxiety and agitation associated with depression.

To assess the effects of treatment on symptoms of anxiety and agitation associated with depression, a data base of 2963 paroxetine treated patients was compared with 554 who received placebo and 1151 on active control. Paroxetine and active control both reduced baseline psychic anxiety more effectively than placebo. Both pharmacological treatments were effective in treating somatic anxiety with active control demonstrating an earlier onset of activity. Neither paroxetine nor active control induced new anxiety symptoms. Paroxetine was superior to placebo in the treatment of agitation at Weeks 4 and 6 and to active control at Week 4 only. Both paroxetine and active control were more protective against emergent (new) agitation than placebo. There was no difference between the three groups in the incidence of spontaneously reported adverse events indicative of anxiety.


[Atrial natriuretic peptide in diabetes mellitus patients with arterial hypertension].

The basal level of atrial natriuretic peptide (ANP) of the venous blood plasma was investigated in 105 diabetic patients with concomitant arterial hypertension (AH) as well as in 20 healthy persons of the same age. Analysis of the results of investigation was performed with respect to AH type (essential, atherosclerotic, nephrogenic) and expression of cardiac changes. An ANP level in diabetic patients without AH did not differ from that of the controls. In the presence of AH this level was increased 2-10-fold. The highest level of ANP was observed in patients with nephrogenic hypertension and marked cardiac disorders. The results obtained suggest the role of ANP in AH pathogenesis.


[Hormonal regulation of sodium excretion by the kidneys during hunger therapy of obese patients].

Sodium excretion and the blood levels of aldosterone, renin, atrial natriuretic peptide (ANP), and insulin were investigated in 9 women with obesity of alimentary-constitutional type during hunger therapy and resumed nutrition. It has been assumed that restricted sodium excretion with the kidneys during fasting is mainly caused by activation of the renin-angiotensin-aldosterone system, with ANP contributing to it, insulin not playing the major role in this process.


Koala lymphoid cells: analysis of antigen-specific responses.

Bovine serum albumin (BSA) and ovine immunoglobulin (OvIgG) were used to induce humoral immune responses in two koalas which were also painted with 2-4-dinitrofluorobenzene (DNFB) and subsequently tested for local delayed-type hypersensitivity (DTH) reactions. The responses observed support the suggestion that the koala is 'immunologically lazy'. Antibody responses to BSA and OvIgG were not detected until 12 weeks after the initial antigen injection and antigen-specific in vitro proliferative responses by the mononuclear cells (PMC) of immunised animals could not be induced, although these cells did respond to concanavalin A and phytohaemagglutinin. Similarly, DTH responses to DNFB could be elicited in vivo, but took a relatively long time to develop and the PMC of the sensitised koalas were unresponsive to the sensitising antigen in vitro. The absence of proliferation when mixed suspensions of PMC from different koalas were cultured in vitro is consistent with these results.


[Vitamin status of workers in steel-smelting departments of the Karaganda Metallurgy Plant].

The author investigated the vitamin status of workers engaged in steel-smelting at the Karaganda Metallurgy Plant. It was found that the workers of the main occupational groups at the plant were insufficiently provided with vitamins A, C and B due to their low content in the food. The system of medico-prophylactic vitamin administration used for steel workers is ineffective.


[Actual nutrition and health of several groups of rural and urban population of the Republic of Georgia].

The results of the study have shown that the nutrition of rural population is characterized by excessive consumption of bread and baked products, by high content of phosphorus, magnesium and iron, low content of animal proteins, vegetable oils, calcium, vitamins A, ascorbic acid and riboflavin. The incidence of cardiovascular, respiratory and alimentary diseases in this group of population was rather high. The nutrition of students is characterized by excessive consumption of polysaccharides, vegetable oils, thiamine, niacin, ascorbic acid (in winter-spring period), and calcium. Diseases associated with nutrition disorders (obesity, hepatitis, cholecystitis, colitis) are most often recorded in this group of population.


[Effects of docosahexaenoic and eicosapentaenoic acids on the state of metabolites of the prostacyclin I2--thromboxane A2 system in streptozotocin diabetes mellitus].

Data are presented on the level of stable metabolites of prostacyclin I2-thromboxane A2 system in streptozotocin diabetes mellitus in rats. It is shown that simulation of streptozotocin diabetes mellitus leads to the reduction of 6-ketoprostaglandin F1 alpha content in the aortal wall tissue and blood plasma, and to a rise of thromboxane B2 level and the thromboxane B2/6-ketoprostaglandin F1 alpha ratio in the blood plasma. Inclusion of docosahexaenic and eicosapentaenic acid concentrate into the ration of animals with streptozotocin diabetes mellitus is conducive to normalization of the stable metabolite level in the prostacyclin I2-thromboxane A2 system.


[Immediate and late results following endarterectomy of the carotid bifurcation].

In a retrospective study we analysed two groups each consisting of 100 consecutive patients of similar age and sex distribution who underwent surgery for carotid disease with an intervening period of 5 years (group A 1980/82, group B 1986/87) between the collectives. Against a background of changing indications, tactics and techniques the aim of the study was to detect any differences between the two groups. Group A had a higher proportion of coronary and peripheral vascular disease. The states of cerebral ischemia I, II and III were distributed equally, but state IV was seen more frequently in group B (p less than 0.05). The number of shunt/without shunt operations in group A was 97/2, in group B 10/84 (p less than 0.005). The external carotid artery was deobliterated in 58/81 cases group A versus group B (p less than 0.005). We closed the artery by direct suture in 8/31 (p less than 0.005), by autologous venous patch in 53/26 (p less than 0.005) and by Dacron patches in 39/41 patients. In group A the operative mortality was zero and in group B 1 patient died; one patient in group B developed sudden occlusion (with TIA) postoperatively. Transient intra-/postoperative neurological deficits occurred in 1/2, permanent in 4/2 patients (n.s.). 54/25 patients have died up to 31/08/91. Coronary heart disease was the main cause of late complications and deaths in group A (p less than 0.025). Statistically, there was no dependence of neurological deficits on group, sex, age or intraoperative management. Only patients with preoperative PRINDS hat a higher postoperative neurological deficit rate than the others.


[Determination of N'methylnicotinamide and nicotine coenzymes in biological in biological media by the fluorescent method].

Assay of N1-MNA was conducted in 96 urine samples using two methodological variants with external and internal N1-MNA standards. Basing on significant fluctuations of the percent of detecting N1-MNA added to urine, the necessity of using the internal standard was proved. A significant (up to 30%) overestimating of the values in using the external standard makes difficult revealing niacin deficiency. It has been recommended that NAD preparation be used as an internal standard in NAD + NADP assay in the blood, that permits one to simplify significantly the counting and to avoid the universal coefficient (used in literature) of recalculating N1-MNA fluorescence to nicotinamide coenzyme fluorescence because this coefficient is not a constant value.


[Decreased blood pressure in sleep and left ventricular hypertrophy in patients with kidney transplants].

Since left-ventricular hypertrophy (LVH) has been identified as a poor prognostic indicator in patients with secondary hypertension, we investigated 38 renal transplant recipients on antihypertensive medication with 24-h ambulatory blood-pressure measurement (SpaceLabs 90207) and determined their left-ventricular mass by two-dimensional guided M-mode echocardiography. An increased left-ventricular mass correlated with a reduced fall of diastolic blood pressure during sleep (r = 0.29; p less than 0.05), as well as with a reduced fall of mean arterial pressure during sleep (r = 0.31; p less than 0.05). Therefore, a less pronounced afterload during sleep is related to more severe left-ventricular hypertrophy, suggesting a worse cardiovascular prognosis.


[Effects of the use of a multivitamin preparation "Pikovit" (KRKA, Yugoslavia) on providing nursery children with vitamins].

Providing of children aged 3-5 years with vitamins C, B1, B2, B6 and PP was studied before and after intake (during 3 months) of multivitamin "Pikovit" (KRKA, Yugoslavia) by the excretion with urine of ascorbic acid, thiamine, riboflavin, 4-pyridoxic acid and N-methylnicotinamide. Before "Pikovit" intake the mean level of thiamine excretion was close to the lower border of the normal level, while ascorbic acid and N-methylnicotinamide levels were lower than the normal in 73 and 69% of the children studied, respectively. "Pikovit" induced an increase in the mean values of excretion of all vitamins studied except for ascorbic acid. The multivitamin prevented the impairment of children providing with vitamins C and B6, and improved their provision with vitamins B1, B2 and PP. However, the doses of vitamins used proved to be insufficient for complete normalization of the vitamin status in children, therefore it is necessary to use "Pikovit" in higher doses as it is recommended by the firm-manufacturer.


[Long-term blood pressure measurement for evaluating the first dose response of captopril and ramipril in patients with a stimulated renin system].

First-dose-response of captopril 1 x 25 mg (no prodrug) and ramipril 1 x 2.5 mg (prodrug) were compared in two groups of 17 patients with moderate or severe hypertension and stimulated renin-angiotensin system (because of continuous diuretic therapy) by means of 24-h blood-pressure measurement at the 1st and 7th day of therapy. In the ramipril-group the antihypertensive effect started after 2 h, had its maximum (mean: -13/-8 mmHg) after 4 h and remained unchanged for 8 h. The antihypertensive effect was significant for 24 h. There was a slightly but not significant improved blood-pressure reduction at the 7th day compared to the 1st. The captopril-group showed a fast and marked decrease of blood pressure within the first hour, and reached its maximum (mean: -18/-10 mmHg) after 2 h. After 7 h there was no antihypertensive effect detectable. At the 7th day blood-pressure reduction was less pronounced compared to the 1st day. The results show that initial decrease of blood pressure in risk-patients is less severe with prodrug-ACE-inhibitors with slow onset of action so that counterregulation can be activated and prevent severe, fast, ACE-inhibitor-induced hypotension. 24-h-blood-pressure measurement is a sufficient method to evaluate first-dose-response of ACE-inhibitors.


Mutations in phosphofructokinases alter the control characteristics of glycolysis in vivo in Saccharomyces cerevisiae.

Ethanol and CO2 production from glucose by non-proliferating suspensions of aerobically-grown, glucose-derepressed wild-type Saccharomyces cerevisiae is inhibited by O2; monitoring by mass spectrometry provides a direct method for measurement of the Pasteur effect. Under aerobic conditions, that part of the CO2 evolved equivalent to the O2 consumed, is produced by respiration: subtraction of this respiratory CO2 from the total gives CO2 produced by aerobic glycolysis. Pasteur quotients (anaerobic CO2/aerobic glycolytic CO2) were within the range 1.2 to 3.0. The Pasteur effect was not observed in the presence of carbonyl cyanide m-chlorophenylhydrazone, an uncoupler of mitochondrial energy metabolism, or in a rho degree cytoplasmic petite mutant. A 'non-allosteric' mutant with an altered regulatory subunit of phosphofructokinase showed no Pasteur effect. Strains bearing a nonsense mutation pfk1 in the catalytic subunit of soluble phosphofructokinase (PFKI) also showed no Pasteur effect; the residual fermentative activity of this strain was dependent on PFKII, the particulate phosphofructokinase. A double mutant lacking both PFKI and glucose-6-phosphate dehydrogenase showed similar characteristics to those of the single pfk1 mutant; this indicates that the hexose monophosphate shunt is not acting to bypass the phosphofructokinase block. A 'hyper-allosteric' mutant altered in the regulatory subunit encoded by the gene PFK2 showed characteristics of glucose fermentation and ethanol oxidation very similar to those of wild-type organisms. These results indicate that either of the two phosphofructokinases can carry out glycolysis.


[Results of prophylactic vitamin administration of schoolchildren in Tbilisi].

The data are presented on providing with vitamins of schoolchildren in Tbilisi. Significant disorders were revealed in their providing with vitamins due to insufficient content of vitamins in daily food rations of the schoolchildren investigated. To correct their vitamin status an additional vitamin administration to schoolchildren with the multivitamin compound "Hexavitum" was conducted and its positive effect on the parameters of their physical and mental development was recorded.


Ketones in resin composites. Effect of ketone content and monomer composition on selected mechanical properties.

To optimize the improvements by diketones of the mechanical properties of resin composites, diacetyl was added to two different monomer mixtures in different quantities. There was a positive correlation between content of diacetyl and tensile strength, flexural strength, and modulus of elasticity, respectively, of both the BISGMA/TEGDMA- and the UEDMA/HEMA-based materials. Addition of diacetyl did not influence the modulus of resilience significantly. Addition of diacetyl resulted in increases in mechanical properties which were of the same relative size for BISGMA/TEGMA-based materials as for UEDMA/HEMA-based materials. However, because of higher control values, except for modulus of elasticity, the properties of UEDMA/HEMA-based composites were superior to those of the BIGSMA/TEGDMA-based materials. A content of approximately 24 mole% diacetyl seemed to have optimum effect on mechanical properties, giving a mean increase of 25% in tensile strength, flexural strength, and modulus of elasticity.


Is vascular angiopathy following intracranial aneurysm rupture immunologically mediated?

Immunofluorescence studies showed the presence of IgM and/or C3 in the endothelium of intracranial aneurysms in 5 out of 6 patients with subarachnoid haemorrhage (SAH). In none of them were the immune deposits found in the gyrus rectus. Cortical tissue of 4 epileptic patients which served as a control give negative results. Serum studies on femoral artery wall used as an antigenic substrate did not reveal circulating antibodies of the IgM or IgG class. Our studies strongly suggest that the IgM and/or C3 immune deposits located in the endothelium of intracranial arteries may play a role in post SAH neurological complications.


Unilateral swelling of the lower abdominal wall. Unusual clinical manifestation of an upper lumbar disc herniation.

Circumscribed unilateral paralysis of abdominal muscles is a rare clinical feature and has previously been described in diabetic neuropathies and traumatic or non-traumatic compressive neuropathies. The paper describes a case presenting with transversus abdominis muscle paralysis and burning paraesthesia in the anterolateral aspect of the thigh caused by a lateral L2-L3 disc herniation. Abdominal echography and the EMG investigation led to the suspicion of a disc prolapse which was eventually verified by myelography completed with a CT scan. Surgery confirmed L2 root compression by a large calcified herniation in the intervertebral foramen L2-L3. The anatomical principles are recalled to explain the clinical manifestations.


Cardiovascular complications of cocaine abuse.

Cocaine abuse may lead to serious cardiac complications, including myocardial ischemia and infarction, myocarditis, cardiomyopathy and arrhythmias. With concomitant use of alcohol and cocaine, cocaethylene is produced by hepatic transformation. Cocaethylene is now thought to be primarily responsible for the deaths that occur among cocaine abusers. Treatment of cardiovascular complications focuses on cocaine-induced ischemia, hypertension and arrhythmias. The use of thrombolytic agents in myocardial infarction remains controversial. Concurrent detoxification with bromocriptine and norepinephrine is recommended.


Effects of amlodipine on myocardial infarction, infarct expansion, and ventricular geometry in the rat.

Infarct expansion remains an important sequela of myocardial infarction. Both angiotensin converting enzyme inhibitors and intravenous nitrates reduce early infarct expansion in humans. This is believed to be caused by the reduction in left ventricular systolic wall stress that results from the arteriolar vasodilatation they produce. Patients are frequently already receiving calcium channel blockers at the time of infarction or these drugs are sometimes administered in the perimyocardial infarction period. The calcium blockers of the dihydropyridine class might be expected to modify infarct expansion. However, their effect on this process has not been studied. We therefore evaluated the effect of early treatment with the calcium blocker amlodipine, a potent arteriolar vasodilator with minimal negative inotropic properties, on chronic myocardial infarction in the rat. Permanent left coronary occlusion was created after pretreatment with amlodipine, 0.25 mg/kg (low dose) or 1.0 mg/kg (high dose), or placebo, intravenously twice a day, and continued for 7 days after infarction. Hearts (n = 50) were perfusion fixed 21 days after infarction and analyzed for infarct extent, scar thickness, left ventricular shape and size, and expansion index. Both doses decreased mean blood pressure (119 +/- 3 to 99 +/- 5 mm Hg low dose, p = 0.004; 110 +/- 5 to 84 +/- 4 mm Hg high dose, p = 0.0003), with reflex tachycardia only after the high dose (heart rate 395 +/- 9 to 434 +/- 11, p = 0.001). Infarct extent was equal in the three groups (39 +/- 2%, 41 +/- 2%, and 41 +/- 3% of left ventricular circumference for control, low, and high doses, respectively). The three groups did not differ significantly with regard to left ventricular cavity cross-sectional area (80 +/- 4, 77 +/- 3, and 87 +/- 3 mm2, control, low, and high doses, respectively; p = 0.07 high dose vs control), mean scar thickness (0.74 +/- 0.06, 0.73 +/- 0.05, and 0.65 +/- 0.06 mm, control, low, and high doses, respectively; p = NS), and expansion index (1.52 +/- 0.10, 1.58 +/- 0.12, and 1.95 +/- 0.19, control, low, and high doses, respectively; p = 0.08 high dose vs control). In the subgroup with larger infarcts (infarct extent greater than 0.39 of left ventricle), the expansion index was higher in the high-dose group (2.37 +/- 0.23 vs 1.64 +/- 0.17 control; p = 0.04). In this model, treatment with amlodipine does not limit infarct extent or reduce early infarct expansion and left ventricular dilatation, even when initiated before infarction.(ABSTRACT TRUNCATED AT 400 WORDS)


Effect of captopril on the prevention and regression of myocardial cell hypertrophy and interstitial fibrosis in pressure overload cardiac hypertrophy.

This article reports on the effects of captopril on both the prevention and the regression of myocardial cell hypertrophy and interstitial fibrosis in experimental animals (rats) with pressure overloaded hearts. Constriction of the abdominal aorta just below the diaphragm during periods of 20 days (prevention experiment) and 40 days (regression experiment) resulted in hypertension and cardiac hypertrophy. In the prevention experiment, captopril was able to inhibit the development of high blood pressure levels and cardiac hypertrophy in aortic-constricted rats. Similarly, the treatment of sham-operated rats with captopril led to a reduction in the weight of the heart and in the myocyte diameter compared with controls. The myocyte volume fraction of the left ventricles of both aortic-constricted and sham-operated animals that were treated with captopril was significantly diminished compared with that of the control group. The interstitial collagen volume fraction of all experimental groups was elevated as compared with the control group. As a consequence, the ratios of myocytes to interstitial collagen in groups of aortic-constricted rats, aortic-constricted rats that were treated with captopril, and sham-operated rats that were treated with captopril were reduced compared with the control group; that is, although captopril was able to prevent myocardial cell hypertrophy after aortic constriction, it could not prevent the maintenance of a normal ratio of myocytes to interstitial collagen, which was due to increased collagen volume fraction. In the regression experiment, captopril lowered high blood pressure levels and augmented heart weights to control values. The mean myocyte transverse diameter in aortic-constricted rats that were treated with captopril was significantly smaller than that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)


The classroom as clinic: applications for a method of teaching clinical reasoning.

This study examined the efficacy of one method for teaching diagnostic reasoning to occupational therapy students. During a clinical reasoning seminar in their first academic year, 80 entry-level occupational therapy master's degree students in three successive classes were given three different levels of exposure to classroom-as-clinic or in-class evaluations of adults with physical or psychosocial disabilities. During the following summer, most students completed their first Level II fieldwork experience. Students' grades for a second-year classroom-as-clinic experience with adults with physical disabilities were then compared across groups to determine the relative effect of the different seminar formats and fieldwork experiences. Students who had experienced in-class evaluations during their first academic year wrote significantly more accurate second-year evaluations than those who had not. Students who had completed psychosocial Level II fieldwork experiences were as accurate on their evaluations as students who had had physical dysfunction fieldwork experiences. The results suggest that in-class evaluations improve students' diagnostic reasoning skills.


Dehydroepiandrosterone prevents dexamethasone-induced hypertension in rats.

Dehydroepiandrosterone (DHEA) is an endogenous steroid having a wide variety of biological and biochemical effects. In the present study, we have examined the role of DHEA on various rodent models of experimental hypertension. Sprague-Dawley rats were given subcutaneous injections of 1.5 mg dexamethasone every alternate day, resulting in an increase in systolic blood pressure within 1 wk. Interestingly, administration of a pharmacological dose of 1.5, 3, or 7.5 mg DHEA along with dexamethasone prevented dexamethasone-induced hypertension in a dose-dependent manner. DHEA had no effect on the hypertension induced by deoxycorticosterone acetate (DOCA)-salt administration using uninephrectomized rats or on the genetic model of spontaneously hypertensive rats. Dexamethasone administration resulted in a significant weight loss in rats, which was not prevented by simultaneous administration of DHEA. These results indicate that dexamethasone-mediated weight loss may involve mechanisms separate from its hypertensive action. Dexamethasone treatment resulted in a significant decrease in food consumption that was not reversed by DHEA. It is concluded that DHEA at doses above physiological levels when given subcutaneously has no effect on DOCA-salt or a genetic model of hypertension but has a beneficial effect on dexamethasone-induced hypertension.


Generation of the neutrophil-activating peptide-2 by cathepsin G and cathepsin G-treated human platelets.

The neutrophil-activating peptide-2 (NAP-2) is a cytokine that is generated by the proteolytic cleavage of a precursor protein and that causes neutrophil degranulation and chemotaxis. NAP-2 precursors are produced in platelets and are normally found in the circulation. We showed that NAP-2 is generated by the action of neutrophil cathepsin G on two of the precursors, the connective tissue-activating peptide-III (CTAP-III) and beta-thromboglobulin (beta-TG). However, neutrophil elastase degraded the precursors to inactive peptides. The specific binding of cathepsin G to platelets caused the platelets to secrete NAP-2, and cathepsin G bound to the platelets could still generate NAP-2 from its precursor proteins. In addition, activated neutrophils in the presence of platelets generated NAP-2 from its precursors and caused platelets to secrete NAP-2. These studies demonstrate a unique mechanism for the activation of neutrophils through the interaction of neutrophils, platelets, and NAP-2 precursors that are released either by activated platelets or are present in circulation. It is therefore possible that NAP-2 may be generated at sites where aggregations of neutrophils and platelets occur in vessels such as pulmonary capillaries in patients with the adult respiratory distress syndrome and coronary arteries in patients with evolving myocardial infarctions.


Bronchodilating effect of ipratropium bromide inhalation powder and aerosol in children and adolescents with stable bronchial asthma.

The purpose of this study was to compare the bronchodilating effect of ipratropium bromide (IB) administered by a conventional Ingelheim powder device system (IPI) and by a metered dose inhaler (MDI) in children and adolescents with stable bronchial asthma. Seventy patients, aged 7 to 16 years, with stable bronchial asthma from our outpatient clinic were tested for bronchial responsiveness to inhaled IB. Fifteen (21%) of the 70 subjects were found to have a substantial bronchial response to inhalation of 40 micrograms IB, i.e. at least 15% increase in FEV1 30 min after inhalation; the remaining 55 subjects had less than 15% increase in FEV1. No relationship between severity of asthma, age or sex and bronchial responsiveness to inhaled IB was found. Among the 15 subjects who had substantial bronchial response to IB, the increase in FEV1 after inhalation of fenoterol tended to be greater than the response to inhaled IB, although this did not reach statistical significance. Responders, i.e. subjects who had at least 15% increase in FEV1 after inhalation of IB, took part in a double-blind, cross-over study of the bronchodilating effect of 40 micrograms IB delivered by IPI and MDI. We found no significant differences in the bronchodilating effect during a 6-h follow-up. Maximum bronchodilating effect of IB was reached after 30 min and the maximum response lasted for 90 min. No side or adverse effects were observed following inhalation of IB.(ABSTRACT TRUNCATED AT 250 WORDS)


Assessment of acute myocardial infarction by nuclear imaging techniques.

In recent years, nuclear cardiology techniques have been successfully applied in patients with acute myocardial infarction. These scintigraphic measurements have provided important diagnostic, therapeutic, and prognostic information based on the extent of myocardial damage and the functional reserve of the left ventricle. In particular, in the thrombolytic era, myocardial perfusion imaging and radionuclide angiography have been shown to be valuable methods for studying the effects of reperfusion on the extent of myocardial damage. Nuclear magnetic resonance imaging, preferably with contrast enhancement, is one of the newly developed nuclear imaging techniques that have probably the greatest potential in accurately delineating myocardial infarct size and in evaluating left ventricular function. Radionuclide procedures, on the other hand, employ more biologically oriented tracers and are therefore capable of monitoring biochemical changes in the course of acute myocardial infarction.


The avian muscle spindle.

The literature on the morphology and physiology of the avian muscle spindle is reviewed, with emphasis placed on the period from 1960 to 1991. Traits similar to or different from mammalian spindles are recognized. Apart from receptors with low intrafusal fiber counts, bird spindles contain two or three types of intrafusal fiber. Unlike that of mammals, the equatorial fiber structure in birds does not lend itself to classification into nuclear bag and nuclear chain types. Avian intrafusal fibers are separable into types based on differences in myosin heavy chain composition and motor innervation, but apportionment of these fiber types to individual spindles is more variable in birds than in mammals. There is morphological evidence in birds for the existence of both gamma and beta innervation; however, confirmation of these systems by physiological experiments is at best sketchy. A general lack of physiological data is currently the greatest drawback to a better understanding of how the avian receptor works, and what role it plays in sensorimotor integration.


Leber congenital amaurosis in an infant with Down syndrome.

A male infant had defects of atrial and ventricular septa and trisomy 21. At 2 months of age, the patient had markedly sluggish pupillary reactions to light OU. Searching nystagmus, multiple chorioretinal atrophic spots in mottled retinas, and unrecordable electroretinograms also were found in the patient when he was 6 months of age. We believe that this infant represents a rare case of Leber congenital amaurosis in association with Down syndrome.


Effect of blood transfusion on recurrence of head and neck carcinoma. Retrospective review and meta-analysis.

To study the effect of transfusion on recurrence of squamous cell carcinoma of the head and neck, we analyzed the records of 143 patients with stage II through IV squamous cell carcinoma of the supraglottic larynx or hypopharynx for whom follow-up to recurrence or 5 years after surgical therapy was available. Variables studied were age, gender, TNM staging, duration of operation, estimated blood loss, units of blood products transfused, surgical margins, number of pathologic nodes, radiotherapy, chemotherapy, hematocrit, and serum albumin. Multivariate logistic regression demonstrated that transfusion, number of pathologic nodes, and preoperative hematocrit were significantly related to recurrence. The univariate odds ratio for tumor recurrence in patients receiving any blood products was 3.2 (95% confidence interval 1.5 to 6.9; p = .004). Based on a meta-analysis of the data from this study and the five published studies, the combined odds ratio for recurrence after transfusion was 2.6 (95% confidence interval 1.9 to 3.7; p less than .0001). These data identify a clinically important adverse effect of transfusion of blood products on tumor recurrence in patients with advanced head and neck cancer. We recommend a policy of blood conservation surgery to enhance cancer control, and we encourage further research to clarify the mechanism(s) of this effect.


GAP-43 gene expression is increased in anterior horn cells of amyotrophic lateral sclerosis.

In amyotrophic lateral sclerosis (ALS), neuronal loss and axonal degeneration occur in motor neurons. Although there is limited axonal regeneration, surviving motor neurons send collateral sprouts to denervated muscle fibers. GAP-43, a protein enriched in growth cones and synaptic terminals, is thought to have a role in axonal elongation and synaptogenesis. GAP-43 messenger RNA (mRNA) expression was evaluated in ALS spinal cords using Northern blot analysis and in situ hybridization to assess whether surviving neurons can mount an appropriate response to injury. There was a two- to four-fold increase in GAP-43 mRNA in ALS that localized to the anterior horn cells. The increase in GAP-43 mRNA indicates that the mechanism which leads to degeneration in ALS does not compromise the neuron's capacity for vigorous expression of growth-associated proteins.


[Antibiotic sensitivity and pathogenetic factors of hospital strains of Pseudomonas aeruginosa isolated from patients treated in a resuscitation unit].

Strains of Pseudomonas aeruginosa were isolated from patients treated in the Centre of Thermal Affections in 1985-1989. It was shown that 72.9, 59.3, 33.8 and 54.2 per cent of the isolates were sensitive to cefotaxime, tobramycin, gentamicin and polymyxin, respectively. The study of pathogenicity factors of the isolates revealed that 83 per cent of the strains produced thermolabile enterotoxin, 79.6 per cent of the strains had adhesive activity and 71.1 per cent of the strains produced hemolysin. The study detected combinations of various pathogenicity factors. 42.3 per cent of the isolates had both adhesive and enterotoxigenic properties. Adhesiveness and hemolytic activity were shown by 13.5 per cent of the strains. 16.9 per cent of the strains produced both enterotoxin and hemolysin. Adhesive activity, enterotoxigenicity and hemolysin production were observed in 6.7 per cent of the strains. It was noted that the strains of P. aeruginosa resistant to polymyxin mainly produced enterotoxin (18.6 per cent) and those resistant to cefotaxime had adhesive activity (34.0 per cent).


[Antibiotic sensitivity of Vibrio cholerae 01 isolated from environmental objects].

The sensitivity of 252 Vibrio cholerae-O1 strains isolated from environmental objects to antibiotics of various groups was assayed by the method of serial dilutions on solid media. The biological characteristics of the isolates are presented. The Vibrio cholerae isolates with serological variation were the most frequent (36.6 per cent), so are the cultures detected by their sensitivity to the specific phages (87.5 per cent). It was found that changes in some biological properties of the strains did not coincide with the changes in the antibiotic sensitivity. The isolates were highly sensitive to tetracycline, chloramphenicol, gentamicin, erythromycin and rifampicin and less sensitive to novobiocin and the other aminoglycosides. The sensitivity to the beta-lactams was the lowest. The resistance determinants were detected in single strains (6.3 per cent), the kanamycin and novobiocin resistance determinants being detected in 15 out of the 16 strains tested. The study showed that the cultures of Vibrio cholerae-O1 isolated from the environmental objects generally preserved their sensitivity to the diverse group antibiotics.


[Study of the immunosuppressive effect of cyclosporine in experimental studies].

Specific immunosuppressive activity of cyclosporine prepared at the National Research Centre of Antibiotics by using its original producing culture was studied. It inhibited basic cellular immune responses such as DTH and transplant vs. host and prolonged the lifespan of tumor xenografts under the kidney capsule. Cyclosporine also suppressed the humoral immunity. Its inhibitory effect on lymphocyte blast transformation induced by lectins and in mixed lymphocyte cultures was shown in vitro. Cyclosporine inhibited activity of natural killer cells and T-suppressor cells induced by concanavalin A. It was demonstrated on the models of skin allotransplantation in mice and heterotopic transplantation of the heart in rats that cyclosporine prolonged the transplant lifespan. By the main indices of the cellular immunity and in the models of the transplantation immunity, cyclosporine prepared at the National Research Centre of Antibiotics was shown to be similar to that manufactured by Sandoz.


Facet joint block for low back pain: identifying predictors of a good response.

This preliminary study was conducted to identify a facet joint syndrome in low back pain. Ninety maneuvers and symptoms were compared between patients relieved (responders) and those unrelieved (nonresponders) after intraarticular blocks. Fifty-one patients participated in the study; 11 were excluded from evaluation because of unsuccessful injection into the joints as planned. Of the 40 patients included, 20 had four joints anesthetized, 16 had two joints anesthetized, and four had three joints anesthetized. Twenty-two were responders, 17 of whom had more than 90% relief of pain. Only a few variables were more frequent in the responder group: older age, absence of exacerbation by coughing, relief when recumbent, absence of exacerbation by forward flexion and when raising from this flexion, absence of worsening by hyperextension, and extension-rotation. When four of these seven variables were present in the same patient, sensitivity was 81.8% and specificity 77.8%, but this discriminant power must be evaluated in a new population.


Isokinetic arm and leg strength of adults with Down syndrome: a comparative study.

This study compared isokinetic arm (elbow flexion and extension) and leg (knee flexion and extension) strength of individuals with Down syndrome (DS), with mental retardation without DS (NDS), and sedentary young adults with no mental retardation (NMR). Eighteen individuals with DS, NDS, and NMR (11 men and seven women in each group) performed strength tests on a Cybex 340 isokinetic dynamometer. Parameters measured were peak torque (ft/lb), peak torque percent body weight (%BW), average power (watts), and average power %BW. Subjects with mental retardation (ie, DS and NDS groups) performed the test on two separate days with best test results chosen for statistical comparisons. The NMR group performed the test once. In all isokinetic strength parameters measured for arm strength, the NMR group demonstrated significantly higher scores than subjects with DS and NDS. Subjects with DS and NDS displayed similar test results. Similarly, for all the isokinetic strength parameters measured for leg strength, NMR demonstrated significantly higher scores than subjects with DS and NDS. Subjects with NDS, however, averaged significantly higher test results than subjects with DS for leg strength. The results of this study indicate that both subject populations who were mentally retarded exhibited lower arm and leg strength than the NMR subjects. Additionally, subjects with DS demonstrated inferior leg strength when compared to their peers with NDS.


Predicting life satisfaction among adults with physical disabilities.

The perceptions of life satisfaction among adults with physical disabilities were examined in this research. Personal interviews were conducted with 790 adults who had a physical disability. Data were collected using the Center for Epidemiological Studies Depression Scale, Rosenberg's Self-esteem Scale, and the Life 3 Scale. Results from a stepwise multiple regression analysis (n = 344) indicated that leisure satisfaction was the most significant predictor of life satisfaction, explaining 42% of the variance in the life satisfaction scores for this population. An additional 11% of the variance in life satisfaction was explained by scores on financial status, self-esteem, health satisfaction, religious satisfaction, and marital status. Findings from this research highlight the role that leisure satisfaction plays in enhancing life satisfaction among individuals with physical disabilities. Furthermore, the findings suggest that leisure and life satisfaction levels are influenced by employment status and whether the disability was acquired. Discussion centers on the potential contribution that therapeutic recreation can have in the rehabilitation arena.


Therapeutic exercise in chronic neck and back pain.

Research regarding the effect of exercise on chronic benign axial pain is reviewed. Both chronic low back pain (LBP) and chronic neck pain are associated with weakness of the trunk and neck musculature; however, it is unknown whether weakness is a cause or effect. The relationship between incoordination of the neck or trunk musculature and chronic pain is unclear. Exercise is associated with improved strength and endurance and decreased pain in subjects with LBP but the literature is very sparse with respect to chronic neck pain. Range-of-motion is also diminished in those with LBP and improves with exercise, and is associated with abatement in symptoms. No evidence could be found regarding the effect of exercise on segmental motion. Exercise is also associated with improved function, however the mechanism whereby either pain report or function improves is unclear. A greater understanding of the role of exercise will require more specific studies of strength, coordination, motion, function, and pain.


Surgical treatment of enteric 'bud' fistulas in contaminated wounds. A riskless extraperitoneal method using split-thickness skin grafts.

We describe methods and results of a local extraperitoneal method of repairing enterocutaneous "bud" fistulas in abdominal-wall defects. The method is performed with local anesthesia and involves an extraperitoneal closure with skin-graft coverage. Of the nine fistulas so treated, five healed. No patient's postoperative course was set back by the repairs that failed since the method precludes intraperitoneal entrance. Two of three high-output fistulas were successfully repaired with the extraperitoneal method, reversing an otherwise stormy clinical course. We conclude that for epithelialized enterocutaneous fistulas, little is lost if our method of repair fails and much is gained if it is successful in these critically ill patients.


Implantable programmable insulin pumps for the treatment of diabetes.

Implantable programmable pump systems for insulin delivery to the peritoneal cavity or for intravenous insulin delivery have been recently developed. Thirty-one pumps were implanted in 25 patients between 1987 and 1991. At this writing, 76% of patients had functioning pumps. Ninety-two percent of pumps were functioning at 1 year; 89% at 2 years; and 50% at 3 years. No life-threatening complications, either surgical or metabolic, developed. However, 18 patients required 23 outpatient procedures for maintenance of pump function or for pump removal. Metabolic improvement was evidenced by mean and standard deviation of blood glucose levels and by glycosylated hemoglobin levels.


Anatomic and clinical considerations of an internal mammary artery harvest.

In an effort to understand the perceived correlation of internal mammary artery harvesting and wound healing difficulties in the inferior margins of the sternotomy incision, we showed the cutaneous vascular perfusion in the sternal and xiphoid areas by India ink injection studies in cadavers. With these studies, we demonstrated an inherent paucity of nutrient supply to the inferior sternum and xiphoid area. The classic internal mammary artery harvest further compromises the blood supply to these areas. We believe that limiting the most inferior dissection of the internal mammary artery and not including the distal bifurcation leaves intact the lateral musculophrenic nutrient supply to the inferior sternum and xiphoid area and to the ipsilateral abdominal rectus muscle. These guidelines will help to prevent ischemic complications of this area and may aid in reconstruction. If the bifurcation is harvested, we believe that the removal of the avascular xiphoid cartilage at the time of the initial bypass procedure may eliminate this as a potential septic focus.


Unexpected, late cardiovascular effects of surgery for peripheral artery disease. Veterans Affairs Cooperative Study 199.

In reviewing late morbidity of a multicenter clinical trial comparing balloon angioplasty (percutaneous transluminal angioplasty) with bypass surgery for lower-extremity ischemia, an unexpectedly high incidence of adverse systemic events in surgical patients was uncovered. The study was prospective and randomized, and included a total of 263 patients, with follow-up from 2 to 6 years. When end points of related deaths, amputations, and intervention failures were summed, surgery was favored over percutaneous transluminal angioplasty at 4 years. Progression of cardiac and renal dysfunction and mortality differed between groups. A total of 42 deaths were in the group who underwent surgery and 27 in those who underwent percutaneous transluminal angioplasty. The percentage difference in death rate between the two groups increased each year to reach 10% at 5 years. A significant difference in renal function was noted in nine patients who underwent surgery and zero who underwent percutaneous transluminal angioplasty. Myocardial infarctions were greater on follow-up of surgical patients. After 6 years, congestive heart failure had occurred in 19 patients who underwent surgery and eight who underwent percutaneous transluminal angioplasty. The trends in this study of patients with only moderately severe peripheral arterial disease suggest an increased rate of deterioration of cardiac and renal function in patients who have arterial operations. In surgical patients, mortality was 13.1% per year, whereas it was 8.4% for patients treated with percutaneous transluminal angioplasty. Future intervention studies should include long-term follow-up of such cardiovascular events.


Percutaneous transluminal angioplasty in transplant renal arterial stenoses: a long-term follow-up.

Transplant renal artery stenosis is a potentially treatable cause of post-transplant hypertension. Transluminal angioplasty under radiological control facilitates treatment, and in this study the results of 15 consecutive patients treated in one department have been analysed to assess the safety and success of the technique, blood pressure control and transplant function. Technical success was achieved in 14 patients (93%), with zero mortality and only 1 major complication requiring surgical intervention. Blood pressure control was significantly improved by angioplasty, mean blood pressure (diastolic + 1/3 pulse pressure) being lower 4-6 weeks later (P less than 0.05) and a mean of 34 months later (P less than 0.01), and transplant renal function was unaffected. In the treatment of transplant renal artery stenosis percutaneous transluminal angioplasty is effective, safe and often of lasting benefit.


In vivo and in vitro mechanisms of cardiac allograft acceptance in the rat after short treatment with 15-deoxyspergualin.

15-Deoxyspergualin (DSG) has been reported to be a useful immunosuppressive agent already used to inhibit acute rejection in clinical transplantation. In the present study, the survival of heart allograft in rats after a short course of DSG treatment and the mechanisms underlying DSG-induced heart allograft acceptance were studied. Male LEW rats were used as recipients. Male ACI and Wistar rats were used as donors and third-party donors, respectively. Survival of ACI heart grafts in LEW recipients treated with a short course of DSG starting on day 4 after grafting was markedly prolonged, with a mean survival time of 16.6 +/- 5.8 days and 29.8 +/- 3.0 days at doses of 2.5 mg/kg per day and 5 mg/kg per day, respectively. On day 20 after grafting, the mechanism of inducing allograft survival after DSG treatment at a dose of 5 mg/kg per day was analyzed by testing the activation of spleen cells or serum in several assay systems. Spleen cells from DSG-treated rats with surviving heart allografts showed almost no proliferative response against donor strain stimulator cells compared with controls. The cytotoxic activity towards donor strain target cells of spleen cells from DSG-treated rats with surviving heart allografts was lower than that of spleen cells from rats with rejected heart allografts.(ABSTRACT TRUNCATED AT 250 WORDS)


Alpha-human-ANP response to preanesthetic volume expansion and subsequent renal transplantation in diabetic and nondiabetic uremic patients.

alpha-Human atrial natriuretic peptide (ANP) concentrations were measured in 11 diabetic patients with uremia and in 16 nondiabetic uremic controls undergoing renal transplantation after preanesthetic volume expansion with 1000 ml saline solution within 10 min. Two diabetic and seven nondiabetic patients received grafts from living donors and the rest from cadaveric donors. Volume expansion induced a significant increase in the cardiac filling pressures (P less than 0.001), which were kept at that level especially at declamping, which was preceded by mannitol infusion. The baseline mixed venous ANP levels were significantly higher in the diabetic (252 +/- 6 pg/ml) than in the nondiabetic group (103 +/- 14 pg/ml; P less than 0.05). In the nondiabetic group, ANP increased to 177 +/- 40 pg/ml as a response to volume loading (P less than 0.05); it was not clearly changed in the diabetic group. Arterial ANP increased from 267 +/- 55 to 343 +/- 75 pg/ml in the diabetic group (P less than 0.05 and from 102 +/- 17 to 147 +/- 31 pg/ml in the nondiabetic group (P less than 0.05). During transplantation, mixed venous ANP decreased to 125 +/- 55 pg/ml in the diabetic and to 80 +/- 10 pg/ml in the nondiabetic group (P less than 0.001). About 30% of circulating ANP was taken up by the transplant irrespective of postoperative graft function. Two patients in each group showed delayed diuresis requiring postoperative dialysis therapy (22% of all cadaveric transplantations). ANP levels at declamping had no correlation to the outcome of kidney function.


Molecular and crystal structure of the hydrochloride monohydrate of (R)-N-[[1-(4-fluorobenzyl)-2-pyrrolidinyl]methyl]-5-bromo-2,3- dimethoxybenzamide, NCQ 115, a novel dopamine D2 receptor antagonist.

The structure and absolute configuration of the title compound have been determined by single crystal X-ray diffraction analysis. The space group symmetry is R21; the monoclinic unit cell contains two molecules and has the dimensions a = 12.4291(8), b = 7.4511(5), c = 12.7854(7) angstroms and beta = 102.295(7) degrees. The planar conformation of the benzamide moiety is stabilized by an intramolecular (N)H...O bond. Hydrogen bonds connect the chloride anion to the protonated pyrrolidine N atom, and also the crystal water to the carbonyl oxygen of the amide group. The molecule has a folded conformation in which the N-fluorobenzyl substituent of the pyrrolidine ring and the H-bonded pseudo ring of the benzamide moiety are arranged in a sandwich-like manner. In the crystal, intermolecular hydrogen bonds link the drug molecules via the chloride anion and the hydrate molecule into endless helical chains around the twofold axis. The absolute configuration was determined by comparison of the wRtot values, 0.037 and 0.040, calculated using all measured 2027 unique, non-zero reflections and assuming R and S configuration for the chiral center, respectively. Refinement of the structural model with an R configuration resulted in the final indices of R = 0.031 and wR = 0.033 for 1512 reflections with I/delta(I) greater than 3.


Rapid analysis of lambda gt11 fusion proteins without subcloning or lysogen induction.

Current methods of analyzing fusion proteins from lambda gt11 clones involve either subcloning of the insert DNA into a plasmid expression vector or production of lambda gt11 lysogens that are subsequently induced. Both of these methods can be quite time-consuming. The present communication describes a novel strategy for induction of the fusion protein that is both simple and rapid. Liquid cultures of E. coli Y1090R- infected with the lambda gt11 clone were induced directly to produce the fusion protein. Following the preparation of a crude bacterial cell lysate, fusion products were subjected to Western blot analysis.


Specific distribution of an epididymal 50 kDa protein revealed by an anti-Mos protein monoclonal antibody.

An anti-Mos protein monoclonal antibody, 4A6, was used to investigate the distribution of the antigen in the epididymis, in which the c-mos gene is reportedly expressed. The 4A6-reactive antigen was found on the basement membrane and luminal surface of the epithelial cells in the caput epididymis of BALB/c male mice as well as in the proximal corpus epididymis, the cauda epididymis, and the vas deferens. The 4A6 antigen was also found on the luminal surface of the epithelial cells in the epididymis of male germ cell-deficient C57BL/6J-Wv/Wv mice. This confirmed that the 4A6 antigen does not derive entirely from the testicular c-Mos protein but is synthesized in the epididymis. Western blot analysis revealed that the molecular weight of the epididymal 4A6 antigen was 50 kDa, which is unusually high for the c-Mos protein. With its specific distribution in the epididymis, the protein should play a specific role in functions of the epididymis.


Expression and molecular cloning of drought-induced genes in the wild tomato Lycopersicon chilense.

Protein synthesis and translatable mRNA population changes induced during water stress were studied in leaves of a drought-resistant wild relative of tomato, Lycopersicon chilense, using one- and two-dimensional polyacrylamide gel electrophoresis. Under our experimental conditions, water deficit did not significantly affect total protein synthesis capacity. However, it induced biphasic synthesis of a new set of proteins. These newly synthesized proteins resumed to control levels upon rehydration of the plants. Certain drought-induced proteins also accumulated in leaves subjected to heat shock (39 degrees C) or exogenous abscisic acid (ABA, 1 mM) treatments. A cDNA library was constructed using poly(A)+ RNA from leaves of plants exposed to drought stress for 4 days. Differential screening of the library identified three groups of clones corresponding to drought- and ABA-induced mRNAs. Northern blot analysis showed that the genes of selected clones respond differently to the different environmental stresses. Our data clearly demonstrate that water stress alters gene expression in L. chilense plants resulting in the synthesis of new proteins, of which several respond to high temperature stress and others to an osmotic effect. These responses are in part modulated by ABA.


Autoreactive cytotoxic cells in rabbits after prolonged immunostimulation.

Rabbits immunized for 6 months with different amounts of sterile human serum showed weight loss and a decrease in leukocytes. The lymphocyte population reacting to ConA contained autoreactive cells capable of causing 51Cr release from labeled cells from a culture consisting of splenic and peripheral lymphocytic cells from the same animal.


Mitochondrial activity and heat-shock response during morphogenesis in the pathogenic fungus Histoplasma capsulatum.

Changes in temperature and a variety of other stimuli coordinately induce transcription of a specific set of heat-shock genes in all organisms. In the human fungal pathogen Histoplasma capsulatum, a temperature shift from 25 to 37 degrees C acts not only as a signal that causes transcription of heat-shock genes, but also triggers a morphological mycelium- to yeast-phase transition. The temperature-induced morphological transition may be viewed as a heat-shock response followed by cellular adaptation to a higher temperature. We have found that by inducing thermotolerance, i.e., an initial incubation at 34 degrees C, the thermosensitive attenuated Downs strain of H. capsulatum can be made to resemble those of the more temperature-tolerant G222B strain with respect to mitochondrial ATPase activity and electron transport efficiency at elevated temperatures. Furthermore, if the heat-shock response is first elicited by preincubation at milder temperatures or stress, transcription of heat-shock mRNA in mycelial cells of Downs strain that shifted to 37 degrees C proceeds at rates comparable to those of the virulent strains.


MTT assays allow quick and reliable measurement of the response of human tumour cells to photodynamic therapy.

MCF-7 and HT-29 cell lines were selected as a reliable model to examine the possible parameters affecting the sensitivity of tumour cells to photodynamic therapy (PDT) using a dye-laser at 630 nm. The chemical composition of haematoporphyrin derivative (HPD) was determined by high-performance liquid chromatography (HPLC) analysis and was in agreement with reported values. MTT assays were performed to assess the time-dependency of PDT and the influence of the output power and light fluence. The results showed a maximal cytotoxicity 48 h after photoirradiation. The output power (1 or 2 W) did not significantly affect the cytotoxicity when the fluence was constant (20 J/cm2). However, an increase in fluence (10-40 J/cm2) led to a significant enhancement of cytotoxicity until maximal values were reached (30-40 J/cm2). A further increase in fluence (50 J/cm2) proved to induce a fall-off in cytotoxicity related to the intense photobleaching of HPD.


Isolation and characterization of a new Ca2+/calmodulin-dependent protein kinase from isoproterenol-stimulated proliferating rat parotid acinar cells.

A new Ca2+/calmodulin-dependent serine kinase was isolated from rat parotid gland acinar cells following chronic treatment with the beta-agonist isoproterenol. A single-step purification was performed on a calmodulin-agarose affinity column, following solubilization with Triton X-100. Among various substrates tested, bovine galactosyltransferase was the preferred substrate of the kinase, followed by glycogen synthetase greater than histone greater than phosphodiesterase greater than phenylalanine hydroxylase greater than phosphorylase b greater than bovine serum albumin. In comparison, a spleen preparation of Ca2+/calmodulin-dependent kinase did not show galactosyltransferase to be the preferred substrate. Thus, the enzyme would appear to be similar to the human galactosyltransferase-associated kinase. The kinase activity was saturable with 100 microM Ca2+ and 2 microM calmodulin. The molecular mass determined by nondenaturing and sodium dodecyl sulfate polyacrylamide gel electrophoreses was 75 kDa with a pI of 4.3. The Vmax was 3500 mumol/(min.mg protein) with a Km of 1.6 microM for the transferase substrate. Leukotriene C and prostaglandin E2 were found to be specific noncompetitive inhibitors of the rat galactosyltransferase-associated kinase.


Plasma concentration of atrial natriuretic peptide at admission and risk of cardiac death in patients with acute myocardial infarction.

To compare the concentration of plasma atrial natriuretic peptide in patients with acute myocardial infarction with a healthy population and to determine whether a raised concentration of plasma atrial natriuretic peptide at admission was a predictor of mortality after acute myocardial infarction. Patients with acute myocardial infarction were divided into a group with no congestion (class I) and a group with congestion (class II-IV) according to their highest Killip classification in the first 24 hours after infarction. The concentration of plasma atrial natriuretic peptide was measured at admission. On the basis of the concentration of atrial natriuretic peptide measured in the healthy population, patients were separated into two groups: a group with a high (greater than 200 pg/ml) and a group with a low concentration of atrial natriuretic peptide (less than or equal to 200 pg/ml). The patients were followed for three years. 55 patients admitted to the coronary care unit within 12 hours of the appearance of symptoms of acute myocardial infarction were compared with 51 healthy individuals. Plasma atrial natriuretic peptide, Killip class, mortality. The patients had significantly higher concentrations of atrial natriuretic peptide than the healthy controls. Furthermore, patients with congestion had a significantly higher concentration of atrial natriuretic peptide than the uncongested group of patients. Total mortality was 34.5%. In the group with a low concentration of atrial natriuretic peptide the mortality was only 13.6%, whereas mortality was significantly higher (48.5%) in the group with a high concentration. The measurement of atrial natriuretic peptide separated the patients into low and high risk groups after acute myocardial infarction.


Regression of left ventricular hypertrophy in a transplanted heart.

A woman with advanced coronary artery disease underwent heart transplantation. The donor heart had left ventricular hypertrophy. The electrocardiographic and echocardiographic evidence, of left ventricular hypertrophy regressed during follow up; estimated left ventricular mass decreased from 393 g to 171 g. The adaptation of myocardial mass and performance after transplantation is not fully understood. This case illustrates the potential for regression of left ventricular hypertrophy in response to altered loading conditions.


Flushing and rosacea: overview and nursing interventions.

Rosacea is a dynamic facial dermatosis characterized by exacerbations and remissions which affects middle-aged men and women, most of whom flush easily. It is a conspicuous, yet treatable condition. Oral and topical antibiotics, as well as changes in lifestyle and elimination of aggravating factors, are necessary for control. Nurses facilitate compliance with the treatment regimen and optimize patient self-esteem.


Surgical corrections of acne scars.

Acne, a disease of the pilosebaceous gland, may be mild or severe. Scarring, which occurs in both mild and severe disease, produces a variety of skin defects. Careful assessment of the types of scars along with knowledge about the multiple techniques available results in development of the most optimal plan for reconstruction.


N-oleoyl heparin inhibits the amidolytic activity of plasmin and urokinase.

N-desulphated heparin, partially N-acylated on average with three oleoyl chains per molecule, inhibits the amidolytic activity of plasmin (IC50 16 nM) and urokinase (IC50 10mM) when assayed on N-p-tosyl-Gly-Pro-Lys-4-nitroanilide and benzoyl-Ala-Gly-Arg-4-nitroanilide substrates respectively. N-desulphated heparin is not inhibitory. This effect requires the covalent binding of oleoyl residues to heparin and it decreases with increasing concentration of Tris-HCl and non-ionic detergents.


Mutual cross-interference between glucocorticoid receptor and CREB inhibits transactivation in placental cells.

Transcription of the glycoprotein hormone alpha-subunit gene in placental cells is repressed by glucocorticoids, an effect that is mediated through the glucocorticoid receptor (GR). Although the DNA-binding domain of GR has been shown to be important, mutation of the previously identified GR-binding sites in the alpha-subunit promoter fails to abolish repression. Furthermore, mutant receptors in which the DNA-binding specificity is converted to ERE binding or in which the first zinc finger is substituted with that from thyroid receptor remain fully inhibitory, indicating that specific DNA binding to the alpha-subunit gene is not important for repression. Inhibition by GR is only effective when the alpha-subunit promoter is activated by CREB, implicating CREB as the target for GR-mediated repression. Reciprocally, overexpression of CREB interferes with GR-mediated transcriptional activation of MMTV. This activity is not affected by the phosphorylation state of CREB. Despite the mutual cross-interference with activation of gene expression, GR and CREB do not appear to have a high-affinity protein:protein interaction in vitro. Nonetheless, GR and CREB may interact directly in vivo possibly through a third protein or, more likely, may sequester a mutually required target protein.


Discrimination of muscle tension in chronic pain patients and healthy controls.

The purpose of this study was to assess the perception of muscle tension in chronic pain patients and healthy controls. Twenty chronic back pain patients, 20 patients who suffered from temporomandibular pain and dysfunction, and 20 healthy controls were instructed to produce eight different levels of muscle contraction in either the m. masseter or the m. erector spinae. Each level was produced three times; trials were presented in random order. Analyses of the accuracy and the sensitivity of discrimination of muscle tension levels revealed that the patients were less able to perceive muscle contraction levels correctly and that they underestimated their actual levels of muscle tension. Patients and controls did not differ in the extent to which they contracted muscles not involved in the task. Patients suffering from musculoskeletal disorders seem to display a genuine deficit in discrimination of muscle tension that is related to neither local physiological changes at the site of pain, lack of motivation, in-attention, nor fatigue.


Accidental overdose of epidural bupivacaine and sufentanil.

A case is described of an accidental high thoracic epidural infusion of 337.5 mg 0.75% bupivacaine and 180 micrograms sufentanil in less than 30 minutes. It occurred in a post-thoracotomy patient with lung cancer. Severe hypotension and an extensive sensory and motor block developed. Only a mild respiratory depression was seen. The patient recovered after treatment without adverse sequelae.


Dog lymphocyte cultures facilitate the isolation and growth of virulent canine distemper virus.

Optimal conditions for the isolation and growth of virulent canine distemper virus (CDV) in canine thymic and peripheral blood lymphocyte cultures were determined. Peak virus titers were seen from 3 to 6 days postinoculation of lymphocytes and depended on the multiplicity of infection. Dog lymphocytes were at least as susceptible as canine macrophages to infection with virulent CDV. Virus replication in lymphocytes resulted in higher virus titers than in dog lung macrophages. Peripheral blood lymphocytes (PBL) from CDV-immune dogs were as susceptible to CDV as were PBL from susceptible dogs.


Behavioral effects of atrial and brain natriuretic peptides in rats.

The effects of intracerebroventricular administration of rat atrial natriuretic peptide (rANP-1-28) and porcine brain natriuretic peptide-32 (pBNP-32) on passive and active avoidance behavior and on electroconvulsive shock-induced amnesia were studied in rats. The dose range for both peptides was selected to lie between 0.016 and 0.32 nmol. The two peptides were found to facilitate consolidation of the passive avoidance response, to delay extinction of the active avoidance response, and to prevent electroconvulsive shock-induced amnesia in a similar way. It is suggested that some modulatory functions in the central nervous system of the rat, so far attributed to ANP, may in fact involve a dual control by both ANP and BNP, and there is no difference in the biological activity of the two peptides as far as fear-motivated learning behavior is concerned.


Female's DHT controls sex differences in the rat bed nucleus of the accessory olfactory tract.

In the present study the regulatory action of the non-aromatic androgen dihydrotestoterone (DHT) on the volume of the sexually dimorphic bed nucleus of the accessory olfactory tract (BAOT) was investigated. Postnatal treatment with DHT (180 micrograms day-1) between days 6 and 20 (D6-D20) induced, in gonadally intact male rats, a drastic reduction in the overall volume to levels typical in control females. Conversely, the postnatal administration of the anti-androgen cyproterone acetate (CA) to the females from D6-D20 produced an increment in the BAOT volume not dissimilar to that found in control males. These findings reveal that sexual organization in this vomeronasal structure is dependent on the presence of DHT in females during postnatal development.


Anesthesia in pediatric heart transplantation.

Heart transplantation is a widely accepted therapy for end-stage myocardial failure in adults. However, few centers have experience in the treatment of newborns and children. The management of these children from the anesthesiologic viewpoint is demonstrated in our first 10 patients. Ages ranged from 5 days to 5 years; weights ranged from 2900 gm to 16 kg. The children suffered from hypoplastic left heart syndrome (n = 5) or cardiomyopathy (n = 5). Eight patients had to receive catecholamines (dobutamine) before surgery. In neonates cardiopulmonary bypass (CPB) with hypothermic cardiac arrest at 18 degrees C was used; in the older children continuous CPB at 24 degrees to 28 degrees C was performed. Inotropic support during and after weaning from CPB was necessary in all patients who received dobutamine (range, 2 to 10 micrograms/kg/min), epinephrine (range, 0.03 to 1.0 microgram/kg/min), or both. The phosphodiesterase inhibitor enoximone (1.0 mg/kg) was administered to five patients. Prostaglandin E1 was given to four patients, and it was necessary to give additional tolazoline to two patients. Heart transplantation is a challenge for anesthesiologists during the prebypass period as well as during the weaning and early postbypass periods. More experience is necessary to optimize the anesthetic management of these children.


Sorghum mitochondrial atp6: divergent amino extensions to a conserved core polypeptide.

Sorghum mitochondrial atp6 occurs as one copy in the line Tx398 and as two copies in IS1112C. In IS1112C a repeated sequence diverged within the atp6 open reading frames. The two open reading frames (1137 bp, atp6-1; 1002 bp, atp6-2) share an identical conserved region of 756 bp but are flanked 5' by divergent extensions of 246 (atp6-1) or 381 bp (atp6-2). Tx398 carried only atp6-2. The breakpoint of the repeated sequence of the conserved core region corresponds to the amino acid sequence Ser-Pro-Leu-Asp, which is the amino terminus of the proteolytically processed yeast ATP6. The 5' extensions of atp6-1 and atp6-2 were similar to those of rice and maize, respectively. Each open reading is transcribed, however nuclear background influenced transcriptional patterns of atp6-2 in IS1112C.


[The CT diagnosis of hemorrhages into the abdominal musculature resulting from therapeutic procedures on the coagulation system].

Eleven patients treated by anticoagulants or lytic therapy suffered bleeding into the abdominal muscles, resulting in neurological symptoms or those of an acute abdomen. By means of CT it was possible to demonstrate the bleeds and to clarify the differential diagnosis, thereby leading to correct treatment. The possibility of early diagnosis of haemorrhages makes CT a suitable and reliable method.


Multiple venous thromboses and membranous obstruction of inferior vena cava in association with hereditary protein C deficiency: a case report.

A forty year old male presented with multiple dilated venous channels over the whole body involving both inferior and superior vena caval territories, along with features of chronic liver disease and portal hypertension. On investigation, he was found to have membranous obstruction of the inferior vena cava (MOIVC) as well as obstruction of both brachiocephalic and right subclavian veins and 'hereditary protein C deficiency'. He was managed successfully by percutaneous transluminal balloon angioplasty for the inferior vena cava (IVC) obstruction and was doing well on follow-up.


Antibody responses to bacteriophage phi X174 in patients with adenosine deaminase deficiency.

Adenosine deaminase (ADA) deficiency and its biochemical consequences cause severe combined immunodeficiency (SCID). Treatment strategies, designed to correct the biochemical abnormalities, include transplantation of matched bone marrow or haploidentical bone marrow stem cells, repeated partial exchange transfusions with frozen irradiated human red blood cells (RBC), or weekly injection of polyethylene glycol-modified bovine ADA (PEG-ADA). To evaluate the effect of these therapeutic options, we studied in vitro T-cell function and in vivo antibody responses to the T-cell-dependent neoantigen, bacteriophage phi X174, in 10 children with ADA-deficient SCID. In untreated patients, T-cell function was severely depressed, and only minute amounts of antibacteriophage antibody were produced. Transplantation of bone marrow from a matched sibling (one patient) or a phenotypically matched parent (one patient) resulted in a stable graft, normal T-cell function, and substantial but subnormal antibody titers to bacteriophage, with reduced memory and impaired switch from IgM to IgG. Patients receiving T-cell-depleted haploidentical bone marrow stem cells had markedly depressed antibody responses for as long as 3 years posttransplantation, despite rapidly improving T-cell function that became normal in two of four patients. Two methods of enzyme replacement were explored. During treatment with human RBC transfusions, antibody responses to bacteriophage were as severely depressed as in untreated ADA-deficient patients. Treatment with weekly injections of PEG-ADA resulted in normalization of T-cell numbers in all four patients, normal or near-normal T-cell function in two, and mildly but variably improved T-cell function in the other two patients. Quantitatively and qualitatively normal antibody responses to bacteriophage were observed in three of four patients. Assessment of antibody responses to immunization with bacteriophage phi X174 is a useful method to monitor humoral immune function in treated ADA-deficient patients and can be used to estimate when intravenous immunoglobulin (IVIG) prophylaxis may be safely discontinued.


Enhanced expression of interleukin-3 and granulocyte-macrophage colony-stimulating factor receptor subunits in murine hematopoietic cells stimulated with hematopoietic growth factors.

AIC2A and AIC2B are closely related genes encoding components of the receptors for murine interleukin-3 (IL-3) (AIC2A) and granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-5 (AIC2B). We have studied the parallel regulation of expression of these genes in erythroid and myeloid progenitor cell lines. AIC2A and AIC2B transcription was transiently induced in these cells in response to a variety of hematopoietic growth factors, including erythropoietin (EPO), monocyte-CSF, IL-3, GM-CSF, and stem cell factor (SCF or kit ligand). Run-on assays established that the increase occurred mainly at the transcriptional level. Immunoprecipitation experiments confirmed that the increase in messenger RNA expression resulted in augmented synthesis of both AIC2A and AIC2B proteins, and binding studies further showed these proteins to be functional. We observed a fourfold increase in low-affinity IL-3 sites in an erythroid precursor cell line stimulated with EPO, and a threefold increase in GM-CSF high-affinity sites in a myeloid cell line stimulated with IL-3. In addition, we showed that the increase in the IL-3 receptor chain AIC2A in the erythroid precursor cell line correlated with the ability of IL-3 to exert a cooperative effect with EPO in the induction of beta-globin in these cells.


Neuropeptide Y (NPY) synthesis in lymphoblasts and increased plasma NPY in pediatric B-cell precursor leukemia.

Neuropeptide Y (NPY), a regulatory peptide in both the central and peripheral nervous systems, has recently been found in neuroendocrine tumors as well as in the bone marrow of rat and certain autoimmune mice, but not in human bone marrow. To investigate a possible role for NPY in the human hematopoietic system, we have prospectively studied NPY-like immunoreactivity in plasma (P-NPY-LI) and NPY mRNA in bone marrow from children with acute leukemia. Northern blot showed high levels of NPY mRNA in bone marrow and peripheral lymphoblasts from children with B-cell precursor leukemia. In situ hybridization showed NPY mRNA in malignant B-cell precursor lymphoblasts. No NPY mRNA was detected in the bone marrow of children with T-cell leukemia. P-NPY-LI was higher (P less than .001) in 51 children with leukemia (200:50 to 385 pmol/L, median:interquartile range) compared to 51 age-matched healthy controls (37:20 to 52 pmol/L). P-NPY-LI was higher (P less than .001) in those with favorable clinical risk classification. Elevated P-NPY-LI, compared with the upper age-adjusted reference limit, was only found in children with B-cell precursor leukemia (31 of 40), whereas all children with B-cell, T-cell, or myeloid leukemia (n = 11) had normal P-NPY-LI (P less than .001). During the 2- to 46-month follow-up, children with elevated P-NPY-LI had better (P less than .001) outcome compared to those with normal P-NPY-LI (79.4% v 34.6% probability for event-free survival).


A new approach to understanding T cell development: the isolation and characterization of immature CD4-, CD8-, CD3- T cell cDNAs by subtraction cloning.

During T cell development in the mammalian thymus, immature T cells are observed that lack the cell surface markers CD4, CD8, and CD3. A subtracted cDNA library was constructed to isolate cDNAs that are specific for these immature T cells. Tissue-specific expression of 97 individual cDNAs were examined using different cell types by Northern blot analysis, and six cDNAs were analyzed by reverse transcriptase (RT) polymerase chain reaction (PCR) detection of RNA. Approximately 50% of the clones could not be detected on Northern blots, and 40% of the clones were expressed by at least one other cell-type including monocytes, mature T cells, and B cells. Eight cDNA clones appear to be specific for the CD4-, CD8-, CD3- T cell line, used to construct the library, as determined by Northern blot analysis. In addition, 330 cDNA clones were subjected to partial automated DNA sequence determination. Database searches, with both nucleotide and protein translations, revealed cDNAs that exhibit interesting similarities to human cell-cycle gene 1, platelet-derived growth factor receptor, c-fms oncogene (CSF-1) receptor, and members of the immunoglobulin gene superfamily. This approach of employing subtraction coupled with large scale partial cDNA sequence determination can be useful to identify genes that may be involved in early T cell growth, cellular recognition or differentiation.


Multiple dopamine receptors and their implications in medicine.

Two categories of dopamine receptor were identified with classical pharmacological and biochemical techniques. Five different molecular species of dopamine receptor have been identified with molecular biological techniques. Each of the these five receptors can be assigned to one of the two classically identified dopamine receptor categories. The biology of the dopamine receptors can be investigated with molecular biological techniques. Recent pharmacological investigations show that the D1 dopamine receptor may be an important site of action for antiparkinsonian drugs.


Characterization of four B-type cyclin genes of the budding yeast Saccharomyces cerevisiae.

The previously described CLB1 and CLB2 genes encode a closely related pair of B-type cyclins. Here we present the sequences of another related pair of B-type cyclin genes, which we term CLB3 and CLB4. Although CLB1 and CLB2 mRNAs rise in abundance at the time of nuclear division, CLB3 and CLB4 are turned on earlier, rising early in S phase and declining near the end of nuclear division. When all possible single and multiple deletion mutants were constructed, some multiple mutations were lethal, whereas all single mutants were viable. All lethal combinations included the clb2 deletion, whereas the clb1 clb3 clb4 triple mutant was viable, suggesting a key role for CLB2. The inviable multiple clb mutants appeared to have a defect in mitosis. Conditional clb mutants arrested as large budded cells with a G2 DNA content but without any mitotic spindle. Electron microscopy showed that the spindle pole bodies had duplicated but not separated, and no spindle had formed. This suggests that the Clb/Cdc28 kinase may have a relatively direct role in spindle formation. The two groups of Clbs may have distinct roles in spindle formation and elongation.


The safety and feasibility of laparoscopic cholecystectomy.

This study analyzes data from 100 consecutive patients with gallstone disease who underwent laparoscopic cholecystectomy (LC), a surgical technique rapidly emerging as the treatment of choice for this disease. LC has two major advantages: reduction of postoperative pain and a shortened hospital stay. LC was successfully completed in 88 patients, the main cause of conversion to open cholecystectomy being acute or chronic inflammation of the gallbladder. Analysis of risk factors showed that age, obesity, episodes of jaundice, pancreatitis, and acute or chronic cholecystitis are not absolute contraindications to LC. Mortality was absent and the intraoperative morbidity rate was 2%. No lesion of the main bile duct occurred. Seven minor post-operative complications that did not prolong hospital stay were also observed. These figures compare well with the mortality and morbidity of open cholecystectomy, and demonstrate that the significant benefits in terms of patient welfare and hospital costs of LC are not obtained at the expense of increased surgical risk.


Influence of age on fibre type characteristics in the middle gluteal muscle of Andalusian foals.

34 Andalusian foals of both sexes were divided into three age-groups (A = mean age 1 month, B = 7 months, C = 14 months). Samples of the right m. gluteus medius were stained for m-ATPase and NADH-TR in order to determine fibre type composition and size as well as the relative area occupied by each type. Results revealed no statistically significant variation in the proportion of type I fibre among the three age-groups. Significant differences were recorded, however, for type II fibres; an increase in the proportion of IIA fibres was accompanied by a decrease in IIB ones, the difference being most marked between groups A and B. IIB high-oxidative fibres also decreased, while IIB low-oxidative ones showed no significant variation. All fibre types increased significantly in size; types I and IIA recorded a threefold increase, whereas type IIB showed least growth. The relative area occupied by each type increased significantly between groups A and B, but only IIA fibres recorded a significant increase in relative area between groups B and C.


Treatment of hemodialysis fistula pseudoaneurysms with detachable balloons: technique and preliminary results.

Pseudoaneurysm formation is commonly encountered during the life of a dialysis fistula. When these become excessively large or numerous, surgical revision of the graft has been the only treatment option. The authors have treated seven patients by using percutaneous placement of a detachable balloon to occlude a pseudoaneurysm of an upper extremity graft. In four cases the balloon was directed into the pseudoaneurysm from a femoral artery approach. In three cases a direct puncture was made into the pseudoaneurysm for placement of the balloon. The patients were followed up from 1 week to 7 months. Initial technical success was achieved in all seven cases with no complications. Thrombosis of two grafts occurred during the first week after the procedure: one because of herniation of the balloon out of the pseudoaneurysm and one for unknown reasons. One balloon was inadvertently punctured and deflated during subsequent dialysis. Treatment in the other four cases was successful, as evidenced by no further enlargement of the pseudoaneurysms. Direct puncture of the pseudoaneurysm simplifies the procedure and probably decreases the likelihood of balloon herniation because of the orientation of the balloon.


Retrograde approach for contralateral iliac and infrainguinal percutaneous transluminal angioplasty: experience in 100 patients.

To assess the technical feasibility of percutaneous transluminal angioplasty (PTA) performed by means of a retrograde contralateral approach, 201 PTA procedures performed from January 1989 to August 1990 were retrospectively reviewed. In 100 of these cases, the retrograde femoral artery puncture employed for acquisition of the initial diagnostic arteriogram was also used for angioplasty of 173 contralateral arteries. The overall technical success rate for PTA via the contralateral route was 91% (157 of 173 arteries). Overall success for contralateral suprainguinal disease was 94% (61 of 65) and was as follows for infrainguinal disease: femoral, 88% (68 of 77); popliteal, 90% (18 of 20); graft anastomoses, 100% (five of five); and infrapopliteal, 83% (five of six). There were eight procedure-related complications, including one clinically insignificant distal atheroembolization, two sheared balloon fragments, three arterial thromboses, and two postprocedural amputations. There were no puncture-related complications. PTA can be performed with a contralateral retrograde femoral puncture in a high percentage of patients, even when disease is well below the inguinal ligament.


Superior mesenteric artery angioplasty with the TEGwire: usefulness and technical difficulties.

The TEGwire percutaneous transluminal angioplasty balloon on a guide wire was used successfully for dilation of a proximal superior mesenteric arterial stenosis that was not well suited to dilation by conventional angioplasty catheters. After the stenosis was dilated, however, the balloon deflated only partially due to a kink in the TEGwire as it coursed over the acute angle between the aorta and the superior mesenteric artery. Several unsuccessful attempts to correct this problem were made; finally, the partially deflated balloon and the guide catheter had to be withdrawn. Although the TEGwire was used within the guidelines and recommendations of the product, this experience supports the manufacturer's recommendation that the TEGwire system should not be used with narrow-radius vascular curves such as that formed between the superior mesenteric artery and the aorta.


Immunodetection of annexins 1 and 2 in ciliated cells from quail oviduct.

Annexins 1 and 2 are Ca(2+)-binding proteins related to the cytoskeletal proteins which have been reported to bind in a calcium-dependent manner of F-actin and phospholipids in vitro. Proteins immunologically related to the brain 37-kDa annexin 1 and 36-kDa annexin 2 were characterized by immunoblotting epithelial ciliated cells from quail oviduct. They were detected by immunofluorescence in ciliated as well as glandular cells, using antisera and purified antibodies directed against pig brain annexins. The pattern of labeling was found in the apical part of both cell types, with close membrane association. However, a wider distribution was observed in mature ciliated cells: annexins were localized in the well developed cytoskeletal meshwork in which the ciliary apparatus is tightly anchored. After immunogold labeling, annexins 1 and 2 were located in the same area as spectrin 240/235 and at the connection sites of F-actin; both these cytoskeletals proteins were associated with the appendages of the basal body. In contrast, annexins were not detected in immature epithelial cells, while actin and spectrin were present. During ciliogenesis, the staining gradually appeared associated with the lateral and apical membranes. In this cellular model, the annexins may function during exocytosis in gland epithelial cells, where a close cytoskeleton-membrane association is observed; moreover, in ciliated cells, a relationship between cytoskeletal elements of the terminal web and annexins may exist.


An intracellular study of the action of NAN-190 on neurons in the dorsal raphe nucleus of the rat.

Intracellular recordings have been made from neurons in the dorsal raphe (DR) nucleus of the rat to determine the mechanism of action of the arylpiperazine compound NAN-190. Application of NAN-190 (50 microM) alone most frequently caused a hyperpolarization accompanied by a fall in RM and reduced the response to 5-HT and 8-OH-DPAT. After pretreatment of the preparation with the 5-HT-uptake blocker citalopram (10 microM) NAN-190 exerted an excitatory effect. It is concluded that NAN-190 is a partial agonist in the DR nucleus.


Glycine is required for NMDA receptor activation: electrophysiological evidence from intact rat hippocampus.

Fimbrial/commissural stimulation evokes a prolonged negative field potential in stratum radiatum of CA1 region of the rat hippocampus, in situ, upon activation of N-methyl-D-aspartate (NMDA) receptors. This activity can be induced by iontophoresis of NMDLA (50 nA) or glycine (50-100 nA) during low-frequency stimulation. 7-Cl-Kynurenate (10-30 nA) fully antagonized the NMDA receptor-mediated negative wave induced not only by glycine (N = 3) but also by NMDLA (N = 9), suggesting that activation of NMDA receptors is not possible without glycine binding. 7-Cl-Kynurenate also depressed the extracellular negative d.c. potential shifts appearing during iontophoresis of NMDLA. Stimulation with brief, high-frequency trains evoked a negative wave of 2.1 +/- 0.2 mV and 176 +/- 4 ms (N = 20) on the hippocampal field response following the last stimulus. Ketamine (100-200 nA, N = 6) and MK-801 (50-200 nA, N = 7) blocked the negative wave by 74 +/- 13 and 62 +/- 8%, respectively, while glycine (100 nA) potentiated it by 35 +/- 2% (N = 6), indicating that it had a component mediated by NMDA receptors. 7-Cl-Kynurenate (100 nA) antagonized this activity at a comparable rate to the NMDA receptor antagonists (67 +/- 8%, N = 4). A similar negative wave of 0.9 +/- 0.2 mV and 41 +/- 3 ms (N = 12) was evoked in hippocampal slices by high-frequency orthodromic stimulation. Potentiation of this activity upon lowering Mg2+ in ACSF from 1.3 to 0.5 mM further supported that it had an NMDA-mediated component.(ABSTRACT TRUNCATED AT 250 WORDS)


Glucose and oxygen deprivation induces a Ca(2+)-mediated decrease in (Na(+)+K+)-ATPase activity in rat brain slices.

Exposure of rat brain cortical slices to a medium lacking in glucose, oxygen or both glucose and oxygen, resulted in a decrease of the tissue ATP content and a reduction of (Na(+)+K+)-ATPase activity in membranes prepared from the slices. These treatments also inhibited partial reactions of (Na(+)+K+)-ATPase such as Na(+)-dependent phosphorylation and K(+)-stimulated phosphatase, as well as specific binding of [3H]ouabain in membranes prepared from the slices. Glucose deprivation and hypoxia decreased (Na(+)+K+)-ATPase activity in the absence of extracellular Ca2+, but the effects were blocked by 1,2-bis(2-amino-phenoxy)ethane-N,N,N',N'-tetraacetic acid tetra-acetomethyl ester (BAPTA-AM), a chelator of intracellular Ca2+. Metabolic inhibitors mimicked the effects of glucose deprivation and hypoxia. The effect of glucose-free hypoxia was dependent on extracellular Ca2+. It was blocked by Mg2+ at high concentration, bepridil or amiloride, but not by voltage-sensitive Ca2+ channel antagonists and glutamate receptor antagonists. None of the drugs tested here, except for dithiothreitol, affected the inhibitory effect of glucose-free hypoxia on the enzyme activity. In contrast to brain (Na(+)+K+)-ATPase, the kidney enzyme was insensitive to glucose and oxygen deprivation and metabolic inhibitors which depleted the tissue ATP.


Effect of atropine and PCPA on the behavioral modulation of paired-pulse response in the hippocampal CA1 region.

This study investigated the effect of cholinergic and serotonergic inputs on the paired-pulse response in hippocampal CA1 region of behaving rats. Paired-pulses were delivered to the Schaffer collaterals, at an interpulse interval (IPI) of 30 ms, and field responses were recorded at the proximal CA1 apical dendritic layer. Previously, paired-pulse facilitation of the CA1 population spike was shown to be significantly larger during walking than immobility. The muscarinic cholinergic antagonist, atropine sulfate (50 mg/kg i.p.), strongly attenuated this paired-pulse facilitation during walking at given amplitude of the population spike evoked by the first pulse. Parachlorophenylalanine (PCPA; 100 mg/kg i.p. for 3 days), an inhibitor of serotonin synthesis, alone did not change paired-pulse facilitation and the combined action of PCPA and atropine resembled that of atropine alone. The excitatory postsynaptic potentials did not change significantly with behavior or after drugs. Thus, we have shown that the behaviorally dependent modulation of paired-pulse response in the CA1 region is mediated primarily by a cholinergic and not a serotonergic input.


Induction of NMDA receptor-independent long-term potentiation (LTP) in visual cortex of adult rats.

The aim of this study was to examine: (1) whether long-term potentiation (LTP) can be induced in slices from adult rat visual cortex under conditions where inhibition is not antagonized, and (2) the role of N-methyl-D-aspartate (NMDA) receptors in its induction. The field potential elicited in layer III in response to stimulation of the subcortical white matter consisted of a component with peak latency 5-8 ms (N1) and, in most slices, a second component with peak latency 13-19 ms (N2). N1 was generated via both kainate/alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and NMDA receptor activation as revealed by bath application of 6,7-dinitroquinoxaline-2,3-dione (DNQX) and D,L-2-amino-5-phosphonovalerate (APV). N2 was insensitive to APV in most of the slices and was probably polysynaptic since it did not follow stimulation at 0.5 Hz. Tetanic stimulation of the white matter in normal medium induced LTP of N1; in some slices N2 also potentiated. Tetanic stimulation in the presence of APV also induced LTP of N1 and sometimes N2. LTP of N1 induced in APV was of a larger magnitude, and was expressed more quickly than LTP induced in normal medium. It appears that the known reduction of NMDA receptor activity in adult neocortex is accompanied by the development of other mechanisms that maintain synaptic plasticity; these mechanisms seem to operate more efficiently in absence of NMDA receptor activation.


Surgical management of an unusual osteomyelitis involving posterior elements in lumbar spine. A case report.

Improper and invasive management of low back pain may lead to an unexpected tragedy, vertebral osteomyelitis. A 30-year-old female patient suffering from low back pain after a lumbar strain called on a herbal therapist and was given a herb massage with some unknown medication. Unfortunately, a persistent painful ulcer with discharge developed over her back. She was referred to our clinic shortly after where x-ray showed bony destruction over the spinous process, facet, and lamina of L4. Fistulectomy, debridement and spinal fusion were performed. A satisfactory outcome was finally achieved.


Epidemiology of low back pain in the nurses of Chang Gung Memorial Hospital.

Low back pain (LBP) caused by heavy workload or unsuitable work postures not only bothers a great number of persons but also presents a great challenge to the medical profession. This study attempts to analyze the related factors of LBP in nurses from the view of epidemiology, so as to offer a reference in the designing/redesigning of nurses' work and training programs. In this study, 3,212 nurses were surveyed in November 1991. Only 3,159 copies of the questionnaire were valid for investigation; of these, 89.8% were from registered nurses, 6% were from nursing assistants, and 4.2% were from head nurses. Among them, 82.2% were still single, 17.8% were married. Their average age was 25.2 +/- 3.9 years, and they had worked in nursing for an average of 3.9 +/- 3.6 years. Those who worked in the Taipei area and the neurological department were more aware of "low back health care," as well as those who were head nurses and those who had graduated from university. Head nurses had better postures in their daily activities than staff nurses. Head nurses and nurses working in ICUs, and those who were married and had borne children or had a history of abortion had higher incidence of LBP. The risk factors of LBP were related to the age, height, body weight, duration of work, working habits and sitting posture. LBP occurs as frequently as 77.9% in the nursing profession. The causes of LBP were mostly induced by lifting heavy objects (65%) and prolonged sitting (39%). For LBP treatment, physical therapy was the nurses' first choice, and operation was the last choice.


Brainstem glioma after radiation therapy for acute myeloblastic leukemia in a child with Down syndrome. Possible pathogenetic mechanisms.

A 13-year-old boy with Down syndrome (DS) had a brainstem glioma confirmed at autopsy, 10 years after receiving prophylactic cranial irradiation for acute myeloblastic leukemia. There is no clear association of brain tumors with DS; despite a reported link between leukemia and glioma, a causal association with radiation therapy is more likely.