Value and limitations of Doppler echocardiographic determination of mitral valve area in Lutembacher syndrome.

Our objective was to compare the Doppler pressure half-time, Doppler continuity equation and two-dimensional echocardiographic planimetric methods of estimating mitral valve area in Lutembacher syndrome. Fluid dynamics theory predicts that mitral pressure half-time varies inversely with mitral valve area and directly with net chamber compliance and the peak early diastolic transmitral gradient in pure mitral stenosis. The effects of an atrial shunt on these interrelations have not been investigated. Correlation and agreement between mitral valve area estimates obtained by the three methods and that obtained by cardiac catheterization was ascertained in 11 patients with Lutembacher syndrome. Valve areas determined by planimetry and the continuity equation method correlated and agreed well with catheterization measurements (r = 0.83 and 0.81, respectively). The pressure half-time method consistently overestimated mitral valve area; the extent of overestimation was greater in patients with larger atrial shunts. The hemodynamic pressure half-time was independent of the mitral valve area, chamber compliance and the peak transmitral gradient. It was dependent on the magnitude of the atrial shunt, although the correlation obtained was only fair (r = 0.61). These findings suggest that the Doppler pressure half-time method is an inaccurate measure of mitral valve area whenever an atrial shunt coexists with mitral stenosis. Planimetry and the Doppler continuity equation methods yield accurate estimates of mitral valve area in Lutembacher syndrome.


Protection against ischemia during prolonged balloon inflation by distal coronary perfusion with use of an autoperfusion catheter or Fluosol.

The purpose of this report was to study the protective effects of passive and active distal coronary perfusion during prolonged balloon inflation. Prolonged balloon inflation has been proposed to improve immediate and long-term results of percutaneous transluminal coronary angioplasty, but it requires protection against myocardial ischemia. A 30-min balloon occlusion of the left anterior descending artery was performed in three groups of closed chest anesthetized dogs: 1) control (no distal coronary perfusion, n = 13), 2) passive distal coronary perfusion (autoperfusion catheter, n = 10), and 3) active distal coronary perfusion (infusion of the perfluorochemical Fluosol at 30 ml/min, n = 11). At 10 min of balloon inflation, echocardiographic wall motion indexes (scored from 1 [normal] to 5 [dyskinesia]) in the autoperfusion catheter and Fluosol groups (2.4 +/- 1.2 and 2.0 +/- 0.9, respectively) were significantly better than in the control group (3.6 +/- 0.4, p = 0.001), but at 25 min this improvement in wall motion had attenuated and became statistically insignificant when compared with values in the control group. Left ventricular end-diastolic pressure at peak inflation in the Fluosol group (19.5 +/- 5.5 mm Hg) was higher than in the control (7.6 +/- 3.6) and autoperfusion catheter (5.3 +/- 1.4, p < or = 0.01) groups. Pathologic evidence of infarction by tetrazolium staining was seen in three control dogs and in none of the other groups (p = 0.07). Ventricular tachycardia and fibrillation were less frequent in the autoperfusion catheter group (p = 0.02). Three deaths were observed in the control dogs, two in the Fluosol group and none in the dogs with an autoperfusion catheter (p = NS). Passive (the autoperfusion balloon catheter) and active (Fluosol) distal coronary perfusion methods are comparable and better than no perfusion in protecting the myocardium against ischemia produced by prolonged coronary balloon inflation in an experimental canine model. This protection is transient, attenuating after 10 to 25 min, and partial because there was no significant difference in the incidence of myocardial infarction and death among groups, although the latter observations may be related to small sample size.


Intracoronary ultrasound predictors of adverse outcomes after coronary artery interventions.

The purpose of this study was to determine the association between qualitative and quantitative lesion characteristics as assessed by intracoronary ultrasound imaging and adverse outcomes after coronary artery interventions. Restenosis and other adverse outcomes after coronary artery interventions may be difficult to predict from clinical or angiographic data. Intracoronary ultrasound imaging provides additional data that could prove useful. Immediately after successful coronary artery interventions (angiographic residual stenosis < or = 50%), 69 patients underwent intracoronary ultrasound imaging. Images were assessed qualitatively for plaque composition and topography and for dissection. Quantitative data included measurement of minimal lumen diameter, lumen area, plaque area and percent area stenosis at the treatment and adjacent reference sites. Adverse outcome was defined as death, coronary bypass surgery, myocardial infarction or angiographic restenosis. Of the 69 patients, 1 died, 3 had bypass surgery and 1 had a myocardial infarction before planned 6-month repeat catheterization. Two patients were lost to follow-up study. Of the remaining 62 patients, 56 (90%) agreed to follow-up catheterization and 25 (45%) of the 56 had restenosis. Thus, 30 patients had an adverse outcome and 37 had no adverse event. The incidence of dissection detected by ultrasound imaging after an intervention was significantly greater in patients with than in those without a subsequent adverse event (63% vs. 35%, p < 0.05). The severity of dissection also appeared to be related to outcome (p < 0.05). Other qualitative and quantitative variables were not significantly different between the two patient groups. Dissection, as assessed by intracoronary ultrasound imaging after a coronary artery intervention, can identify patients at increased risk of subsequent adverse events. Additional studies are warranted to explore whether such imaging may allow modification of interventional procedures to improve outcome.


Mechanisms of spontaneous shift of surface electrocardiographic configuration during ventricular tachycardia.

The aim of this study was to examine, with multichannel direct cardiac mapping techniques, the mechanisms of spontaneous shift of the QRS configuration in the surface electrocardiogram during episodes of ventricular tachycardia. Ventricular tachycardias demonstrating a spontaneous shift in their surface electrocardiographic (ECG) features are occasionally encountered. It is not known whether such changes in configuration are primarily due to a significant change in the tachycardia site of origin or represent alterations in patterns of endocardial and epicardial activation. Knowledge of these features would be helpful, particularly when ablative therapy is considered for the arrhythmias. During map-directed cardiac surgery, episodes of ventricular tachycardia were mapped from 224 epicardial and endocardial sites. Episodes of pleomorphic tachycardia were identified and isochronal maps of endocardial and epicardial activation were constructed from representative beats before and after the change in configuration. From 52 consecutive patients who underwent detailed intraoperative mapping, 9 patients with pleomorphic ventricular tachycardia were identified in whom 14 episodes of spontaneous shift occurred. An analysis of the epicardial activation patterns revealed that the sites of earliest epicardial breakthrough showed significant alteration at the time of QRS shift in all occurrences. In 10 of these shift episodes, however, the sites of tachycardia origin, located on the endocardial surface, remained closely adjacent (< 2 cm apart). Although these sites of origin remained relatively constant, significant alterations in the patterns of endocardial activation were seen in most episodes. These included changes in the direction of propagation of the wave front of activation and shifts between monoregional and figure eight patterns of activation. In most episodes of pleomorphic ventricular tachycardia, the arrhythmia site of origin remains relatively constant. However, patterns of epicardial activation do undergo significant change and appear to be the major determinant of the QRS configuration on the surface ECG.


Radiofrequency catheter ablation of incessant, medically resistant supraventricular tachycardia in infants and small children.

This study retrospectively evaluates initial experience with radiofrequency catheter ablation in a group of seven infants and small children with a history of incessant, medically resistant supraventricular tachycardia. Before attempted catheter ablation, all patients had had unsuccessful conventional medical therapy (with digoxin or propranolol, or both) and, in addition, each continued to have daily episodes of supraventricular tachycardia while taking amiodarone or a class IC antiarrhythmic agent alone or in combination. The average patient age was 10 months (range 1 to 27) and the average patient weight was 6 kg (range 3 to 13). Electrophysiologic diagnosis included reentrant supraventricular tachycardia in six patients and atrial ectopic tachycardia in one patient. These seven patients underwent a total of nine catheter ablation procedures. The atrial approach to ablation was employed in eight of the nine procedures. Overall, radiofrequency catheter ablation was totally successful in five of the seven patients, partially successful in one patient and unsuccessful in the remaining patient. The combination of radiofrequency catheter ablation and surgical ablation was successful in controlling tachycardia in all patients; with at least 5 months of follow-up study, no patient has had a recurrence of supraventricular tachycardia or reappearance of a delta wave. Surgical ablation of arrhythmogenic substrates in the pediatric age group, although rarely indicated, has been found in the past to be safe and effective. Our initial experience with radiofrequency catheter ablation in infants and small children demonstrates that this procedure is a promising nonpharmacologic therapeutic alternative to surgical ablation.


Effects of quinidine on vascular resistance and sympathetic nerve activity in humans.

The purpose of the present study was to test the hypothesis that intravenous quinidine, unlike procainamide, causes direct vasodilation and reflexly mediated increases in sympathetic nerve activity. Intravenous quinidine can cause significant hypotension. Animal experiments have suggested that quinidine blocks alpha-receptors and also relaxes vascular smooth muscle by a nonadrenergic mechanism. In a recent study we showed that intravenous procainamide causes peripheral vasodilation, hypotension and inhibition of sympathetic nerve activity in humans. Intraarterial procainamide, however, did not cause vasodilation. Postganglionic muscle sympathetic nerve traffic was recorded from the peroneal nerve at the fibular head with tungsten microelectrodes, and forearm blood flow was measured with venous occlusion plethysmography. Central venous pressure was measured directly. The direct effects of quinidine on vascular resistance were determined with brachial artery quinidine infusions and measurement of ipsilateral forearm blood flow. In eight normal subjects intravenous quinidine (8 mg/kg body weight infused for 27 min) decreased mean arterial pressure from 87 +/- 3 (mean +/- SE) to 83 +/- 3 mm Hg, central venous pressure from 6.3 +/- 0.6 to 5.0 +/- 0.7 mm Hg and forearm vascular resistance from 32.2 +/- 5.5 to 25.3 +/- 4.7 U (all p < 0.05). Heart rate increased from 67 +/- 4 to 77 +/- 5 beats/min and muscle sympathetic nerve activity from 288 +/- 70 to 660 +/- 151 U/min (both p < 0.05). In five subjects intravenous nitroprusside that caused similar hemodynamic effects produced similar increases in sympathetic nerve activity. In eight subjects graded infusions of quinidine into the brachial artery (0.37, 0.74 and 1.48 mg/min) produced dose-dependent decreases in ipsilateral forearm vascular resistance and marked attenuation of forearm vasoconstriction caused by the cold pressor test. These data show that quinidine, unlike procainamide, causes vasodilation directly and, when given intravenously, is associated with baroreflex-mediated increases in sympathetic nerve activity.


Myocardial washout of sonicated iopamidol reflects coronary blood flow in the absence of autoregulation.

The aim of the study was to evaluate the relation between measurements derived from myocardial contrast echocardiography and coronary blood flow. Contrast echocardiography has the potential for measuring blood flow. In six open chest anesthetized dogs, the left circumflex coronary artery was cannulated and perfused with blood drawn from the left femoral artery. While adenosine was infused into the circuit, circumflex flow was generated by a calibrated roller pump to the point of abolishing coronary autoregulation. At each of 25 levels of coronary blood flow, paired bolus injections of sonicated iopamidol were performed proximal to a mixing chamber. The perfused area of the left circumflex coronary artery was labeled by radioactive microspheres injected into the perfusion line. Two-dimensional echocardiographic images of the left ventricular short axis were digitized off-line, and myocardial videodensity was measured in the area perfused by the left circumflex coronary artery to generate time-intensity curves. The washout slope of curves showed a good correlation with coronary blood flow, ranging from 0.5 to 12.5 ml/min per g of tissue. This correlation was good both in individual dogs (correlation coefficient [r] ranging from 0.78 to 0.96) and in the group of animals as a whole (r = 0.85). Washout slope also showed a good correlation with coronary diastolic pressure (r = 0.80), which ranged from 23 to 114 mm Hg, suggesting a possible primary effect of pressure on contrast washout. However, coronary blood flow appeared to be a stronger predictor of washout slope (partial F = 26.5, p < 0.001) than did perfusion pressure (partial F = 5.9, p < 0.05 by multiple regression). The injection to injection variability in myocardial washout slope appeared to be high (24%). The gamma variate fitting of curves did not improve the correlation with coronary flow (r = 0.78). Myocardial washout of sonicated iopamidol reflects coronary blood flow in a model in which coronary autoregulation is abolished.


Comparison of left ventricular cryolesions created by liquid nitrogen and nitrous oxide.

This study was designed to compare the cryosurgical lesions produced by liquid nitrogen (-196 degrees C) and nitrous oxide (-76 degrees C). Cryosurgical ablation is a useful method of arrhythmia surgery, but information on the dimensions of cardiac lesions produced by modifying cryoprobe temperature is limited. We compared the dimensions, volumes and electrophysiologic effects of cryolesions created by a liquid nitrogen cryoprobe (Group I) and a nitrous oxide cryoprobe (Group II) on the left ventricular myocardium in the beating canine heart. Exposure time was compared at 1, 2, 3 and 4 min. In each of 18 dogs, two to four lesions were created on the left ventricle and analyzed: 35 lesions created with use of the nitrous oxide cryoprobe and 30 lesions created with the liquid nitrogen cryoprobe. Lesions were measured at the time of induced death 6 weeks postoperatively and assessed by tissue staining with the Masson trichrome technique. The volumes (mm3) of the cryolesions created by the liquid nitrogen cryoprobe were significantly larger (p < 0.05) than those of lesions created by nitrous oxide: 826 +/- 163 versus 493 +/- 197 at 1 min; 1,101 +/- 327 versus 666 +/- 185 at 2 min; 1,356 +/- 318 versus 787 +/- 258 at 3 min and 1,735 +/- 534 versus 923 +/- 376 at 4 min. Decreasing the temperature of the cryoprobe by using liquid nitrogen increases the volume of the lesions. Programmed electrical stimulation before and 6 weeks after cryoablation indicated no arrhythmogenicity.


Smooth muscle cell outgrowth from human atherosclerotic plaque: implications for the assessment of lesion biology.

The purpose of this study was to determine whether the kinetics of smooth muscle cell outgrowth from in vitro explants of human atherosclerotic tissue is dependent on the nature of the atherosclerotic lesion in vivo. The use of techniques for percutaneous in vivo extraction of atherosclerotic plaque has provided the opportunity to study human atheroma-derived smooth muscle cells in culture. However, because of cell selection and changes in phenotype, in vitro findings may not always reflect the biologic properties of the vessel wall, particularly if cells are in culture for prolonged periods. In contrast, studies with nonhuman cells have suggested that the rate at which cells grow out of tissue explants is closely related to the status of the cells in vivo. Atherosclerotic tissue from 41 lesions, including primary plaques (from peripheral arteries and venous bypass conduits) and restenotic lesions (from peripheral arteries and venous conduits) were divided into a total of 1,596 fragments and placed in culture on fibronectin-coated wells. Explant outgrowth was scored over the ensuing 1 month to determine the prevalence and time course of smooth muscle cell outgrowth and the total cellular accumulation. Explant fragments from 40 (98%) of the 41 lesions yielded an outgrowth of smooth muscle cells, confirmed by immunocytochemistry. The mean proportion of adherent explant fragments yielding outgrowth, per lesion, was 69 +/- 4% and was higher in restenotic tissue (81 +/- 3%) than in primary tissue (56 +/- 6%, p < 0.001). For primary lesions, initiation of outgrowth was half-maximal by 8.7 +/- 0.4 days; for restenotic explants, initiation of outgrowth was considerably faster (half-maximal by 5.9 +/- 0.6 days, p < 0.001). Similarly, accumulation of smooth muscle cells around an explant was significantly greater for restenotic lesions (2,791 +/- 631 cells/explant) than for primary lesions (653 +/- 144 cells/explant, p < 0.01). Labeling of first-passage cells with [3H]-thymidine indicated that cells from restenotic lesions had a 1.3-fold greater incorporation rate than did cells from primary lesions (p < 0.05). Smooth muscle cells may be reliably cultivated by explant outgrowth from a variety of human atherosclerotic plaque types obtained intraoperatively or percutaneously. The kinetics of outgrowth from restenotic tissue is distinctly different from that of outgrowth from primary tissue, suggesting a relation between the in vitro outgrowth behavior and the biology of the lesion in vivo. Assessment of smooth muscle cell outgrowth from human atherosclerotic plaque may thus represent a practical and reliable means to investigate the biologic behavior, including growth characteristics, of individual atherosclerotic lesions from human subjects. This technique may also offer a suitable assay system for evaluating therapies designed to inhibit lesion proliferation.


Immediate type of allergy in statis growers.

Three statis growers complaining of immediate allergic symptoms induced by harvesting statis in a plastic greenhouse were examined to clarify their allergic conditions. Distinct positive reactions in the intradermal test and nasal and eye provocation test to the statis extracts were shown in all three cases. High score of radioallergosorbent test (RAST) IgE and remarkable RAST inhibitory effects to the statis extracts were seen in these cases. The immunologic cross-reactivity between statis and chrysanthemum was absent in the RAST inhibition in the patient labeled case C who had complained of the same allergic symptoms when handling chrysanthemums in the off-season for harvesting statis. Those results indicated that the allergic conditions of the present cases were from an immediate type of allergy mediated by a specific IgE antibody to the statis extract.


Blood eosinophil numbers and activity during 24 hours: effects of treatment with budesonide and bambuterol.

The effects of the inhaled corticosteroid budesonide and the oral long-acting beta-agonist bambuterol on circadian variation of blood eosinophil numbers, serum levels of eosinophil cationic protein (ECP), serum eosinophil chemotactic activity (ECA), and serum neutrophil chemotactic activity (NCA) were studied in two groups of patients with allergic asthma. Group 1 (n = 8) had a circadian variation of peak expiratory flow (PEF) 15% or greater, and group 2 (n = 9) had a circadian PEF variation less than 15%. Both groups were randomized and crossover treated for 4 weeks with (A) 0.4 mg budesonide at 8 AM and 8 PM, (B) 20 mg bambuterol at 8 PM, and (C) placebo. At the end of each period blood eosinophil numbers, ECP, ECA, and NCA were measured during 24 hours at 4-hour intervals. No significant differences in the inflammatory parameters could be observed between the groups, although eosinophil numbers tended to be higher in group 1 than in group 2. Highest eosinophil numbers were observed at night. Budesonide reduced both eosinophil numbers and ECP levels, especially at night; bambuterol had no effect on both variables. No circadian variation or treatment effects were observed for ECA and NCA. This study suggests a role for the eosinophil in the nocturnal worsening of asthma, and it demonstrates that budesonide produces, in contrast to bambuterol, a reduction of (nocturnal) eosinophil numbers and activity.


IgE and adenosine 5' triphosphate receptors on immature murine mast cells are functionally linked to signal transduction mechanisms.

Calcium mobilization in response to IgE-receptor cross-linking by antigen was assessed in immature murine mast cells cultured from bone marrow to determine whether the early expression of IgE receptors on such cells may be of functional significance. IgE receptors were expressed by approximately 30% of cells after 1 week in culture and by an increased proportion at 2 and 3 weeks. The ability of a non-IgE-dependent stimulus, adenosine 5' triphosphate (ATP), to increase intracellular calcium in these cells was also tested. Calcium mobilization in large numbers of individual cells was monitored with use of a fluorimetric reagent and flow cytometry. Both antigen and ATP had significant effects on intracellular calcium in cells cultured for as little as 1 week with interleukin-3, when few cells exhibited morphologic or functional characteristics of mast cells. Longer times in culture were associated with an increase in the proportion of cells responding to these stimuli with calcium mobilization, but not with a change in the magnitude of the response. We conclude that the early expression of IgE receptors during mast cell development may be functionally significant, since these receptors appear to be linked to cellular signal transduction mechanisms. The data additionally imply a possible role for ATP in mast cell development.


The effect of IL-4 on human nasal mucosal responses.

Interleukin (IL)-4 causes the dose limiting sensation of nasal congestion when administered systematically at doses of 3 micrograms/kg or higher thrice daily to humans. This side effect was observed in a group of patients treated as part of an immunotherapy protocol for cancer management. To determine the source of this congestion, nasal secretions were collected prospectively in a group of patients at baseline and after provocation with normal saline, methacholine (which stimulates glandular secretion), and histamine (which causes increased vascular permeability). Nasal lavages obtained at baseline and after provocation were analyzed for the presence of these glandular and vascular proteins and inflammatory mediators. Washings and provocations were performed before IL-4 administration, after 24 hours of IL-4 treatment, and after 3 days of treatment, at a time when nasal congestion was maximal. Compared with histamine challenge before IL-4 treatment, the secretion of the plasma proteins albumin and IgG were significantly decreased after 3 days of IL-4 treatment. IL-4 treatment had no apparent effect on methacholine-induced responses. Thus systemically administered IL-4 causes the subjective sensation of nasal congestion, increased histamine in nasal lavages, and the development of vascular unresponsiveness to histamine, without affecting parasympathetic responses to histamine. The relationships among increases in nasal lavage histamine, vascular unresponsiveness to histamine, and the sensation of nasal congestion are unclear.


Induction of granule release by intracellular application of calcium and guanosine-5'-O-(3-thiotriphosphate) in human eosinophils.

The roles of Ca and G proteins in granule release from human eosinophils were examined by use of a patch-clamp technique in single cells. The morphologic changes and the release of eosinophil peroxidase (EPO) from single cells were simultaneously observed. In addition, the expression of small molecular weight guanine nucleotide binding protein (small G protein) mRNA (smg p25A [rab 3] and smg p21 [rab 1]) was investigated. The intracellular application of Ca, 10 mumol/L, and guanosine-5'-O-(3-thiotriphosphate) (GTP-gamma-S), 100 mumol/L, induced fusion of EPO containing granules with the surface membrane, which was associated with a marked increase in membrane capacitance. Ca alone caused a rapid granule release at an early stage of cell dialysis, but most granules still remained in a cluster. GTP-gamma-S alone caused a gradual degranulation. Northern blot analysis revealed the definite expression of smg p21 mRNA with no appreciable expression of smg p25A. These results provide direct evidence of granule fusion by intracellular application of Ca and GTP-gamma-S. In addition, Ca dependent proteins and G proteins act cooperatively in granule release, and these proteins likely regulate the different processes of degranulation. Furthermore, a protein, encoded by smg p21, may be involved in the granule release process in human eosinophils.


Does forced air heating exacerbate asthma?

Asthma morbidity increases in the Canadian autumn coincident with the beginning of home heating. To test the hypothesis that forced air heating exacerbates asthma, 51 subjects were randomly assigned to one of two groups: the intervention (off1-on2) group was instructed to keep their home forced air heating off from September 9 to 17 and then to set the thermostat to 22 degrees C from 8 PM to 8 AM between September 18 and 25. The concurrent control (off1-off2) group was instructed to keep their forced air heating off during the entire study period. Forty-eight of the 51 subjects randomized recorded morning peak flows, asthma symptoms, and bronchodilator use during the study period. For the intervention group, results before compared with during home heating, respectively, were as follows: mean nocturnal awakenings 0.36 versus 0.36; any breathing difficulties an awakening 82% versus 73%; mean morning peak flows 406 lpm versus 409 lpm, a difference of 3.3% +/- 6.7% (SEM), p = 0.6. There was a 95% probability that the true change in peak flows with forced air was less than 2%. For the control group, the comparable results were as follows: mean nocturnal awakening 0.40 versus 0.47; breathing difficulties on awakening 40% versus 47%; mean morning peak flows 400 lpm versus 399 lpm (p = 0.9). The commencement of forced air heating did not exacerbate asthma in this clinical population and is therefore unlikely to be an important problem for most people suffering from asthma.


Effects of inhaled budesonide on serum markers of bone metabolism in children with asthma.

The effects of inhaled glucocorticoids on serum markers of bone formation were evaluated in asthmatic children. Serum total alkaline phosphatase (AP), bone alkaline phosphatase (BAP), osteocalcin, and the novel marker of bone formation, carboxypropeptide of type I procollagen (PICP), were measured. In the cross-sectional part, long-term glucocorticoid users were compared with sodium cromoglycate (SCG) users. In the boys (n = 16), but not in the girls (n = 11), PICP was significantly lower in the glucocorticoid users than in the SCG users. PICP correlated positively with BAP (n = 54; groups combined, r = 0.29, p < 0.05). In the longitudinal part, the effects of inhaled budesonide or SCG, both used for the first time, were evaluated before and after 1 and 5 months of treatment. The budesonide dose was 800 micrograms/m2/day for 1 month and thereafter half of that. The SCG dose was 30 mg/day throughout the study. Only during budesonide use did osteocalcin and PICP decrease, the median osteocalcin by 8% at 1 month (p < 0.05) and by 6% at 5 months (n = 15), and PICP by 5% at 1 month (p < 0.05) and by 28% at 5 months (n = 7, p < 0.01). AP and BAP did not change significantly. Decreased PICP suggests decreased bone formation rate. PICP might be clinically useful as a marker of early adverse effects of glucocorticoids on bone.


Passive cutaneous anaphylaxis in mouse skin is associated with local accumulation of interleukin-6 mRNA and immunoreactive interleukin-6 protein.

We used a BALB/c model of passive cutaneous anaphylaxis (PCA), an IgE-mediated, mast cell-dependent reaction, to demonstrate the early production of the proinflammatory cytokine interleukin-6 (IL-6) mRNA and protein product. Northern blot analysis detects IL-6 mRNA 1, and 2 hours after antigen challenge (dinitrophenyl30-40 human serum albumin [DNP30-40-HSA]) and in situ hybridization reveals that it is primarily cells with round-to-oval nuclei within the dermis (1 to 3 per high-power field) expressing IL-6 mRNA. Immunohistochemistry revealed perinuclear and cytoplasmic staining for immunoreactive IL-6 in mononuclear dermal cells and also cells within the basal keratinocyte layer. Injection of recombinant murine IL-6 (rmIL-6) either systemically or locally during antidinitrophenyl IgE skin sensitization resulted in increased vasopermeability at the PCA site after DNP30-40-HSA. However, this increased permeability was not associated with a change in the character of the cellular infiltrate at the PCA site 8 hours later. Although the specific role of IL-6 in the generation of the allergic response remains unknown, its detection during PCA unequivocally demonstrates that IL-6 be considered one of the mediators identified in inflammation that follows allergic reactions.


Protective activity of inhaled nonsteroidal antiinflammatory drugs on bronchial responsiveness to ultrasonically nebulized water.

Relatively high doses of oral aspirin are needed to afford a significant protective effect against the bronchial obstructive reaction to ultrasonically nebulized distilled water (UNDW) in asthmatic patients. Sodium salicylate at similar doses and indomethacin at normal dose afford no protection. The present study was undertaken to assess the protective activity of these drugs taken by inhalation. Thirteen asthmatic patients performed two UNDW challenges 20 minutes and 24 hours after inhalation of 900 mg lysine acetylsalicylate (L-ASA) or placebo. The volume of UNDW causing a 20% fall in FEV1 (UNDW PD20) was calculated by linear interpolation on the dose-response curve. UNDW response after placebo was not significantly different from the preliminary test (PD20 4.3 +/- 0.7 and 4.1 +/- 04 ml, respectively, mean +/- SE), whereas after L-ASA, UNDW PD20 increased to 17 +/- 2.7 ml (p < 0.01 vs placebo) and remained significantly increased after 24 hours. In another group of 12 patients under the same experimental conditions, an equivalent dose of inhaled sodium salicylate caused no effect. Finally, in a third group of asthmatic patients pretreatment with inhaled indomethacin at two dose levels (6 patients, 25 mg; 10 patients, 50 mg) resulted in a significant dose-related protective effect. These findings indicate that inhaled indomethacin and especially L-ASA exert against UNDW-induced bronchoconstriction a potent protective effect, which appears to be mediated by inhibition of local prostaglandin synthesis in the airways. This fact could have therapeutic implications.


The protective effect of low-dose inhaled fenoterol against methacholine and exercise-induced bronchoconstriction in asthma: a dose-response study.

We compared in a randomized, double-blind study the protective effect of low doses of fenoterol on the airway response to exercise during cold air breathing and an inhalation challenge with methacholine. In six asymptomatic asthmatic persons (mean age, 20.3 years) exercise and methacholine challenges were performed under control conditions and 15 minutes after the inhalation from a metered-dose inhaler of either placebo or 30, 50, 100, and 200 micrograms fenoterol, resulting in 12 separate study sessions within a 3-week period. Airway response was determined by measuring specific airway resistance (sRaw). Exercise tests were standardized by maintaining a constant respiratory heat exchange, with an average (range) of 1.28 (1.15 to 1.45) kcal/min. Methacholine was inhaled at increasing doses until sRaw had doubled (PD100sRaw). Mean postexertional increase of sRaw (SD) after control conditions, placebo, and 30, 50, 100, and 200 micrograms fenoterol aerosol was 27.8 (6.9), 28.9 (10.0), 7.20 (2.7), 9.33 (3.8), 5.57 (2.3), and 5.28 (1.6) cm H2O.s. Fenoterol aerosol was equally effective at all doses administered, whereas methacholine-induced bronchoconstriction was attenuated in a dose-dependent manner. From these observations we suggest that low-dose fenoterol protects against bronchoconstriction induced by exercise, a naturally occurring stimulus reflecting airway hyperresponsiveness.


Comparison of body mass indexes and cutoff points for estimating the prevalence of overweight in Hispanic women.

The anthropometric standards used for estimating the prevalence of overweight among Hispanic groups are generally developed in other populations. Our purpose was to identify appropriate anthropometric indicators and cutoff points for Hispanic women. Data from the Hispanic Health and Nutrition Examination Survey HHANES (1982-1984) included 1,784 Mexican American, 479 Cuban American, and 750 Puerto Rico women aged 25 to 74 years. The body mass indexes examined were weight/standing height1.5, weight/standing height2, weight/sitting height1.5, and weight/sitting height2. Appropriateness was based on correlation of the index with triceps and subscapular skinfold measurements and lack of association with standing or sitting height. The most appropriate indicator was weight/standing height2. To estimate overweight, the 85th percentiles for weight/standing height2 were obtained from the 20- to 29-year-olds in HHANES and the second National Health and Nutrition Examination Survey (NHANES II). For 10-year age intervals, the differences in proportions of women above those cutoff points were compared with a modified t test. The mean estimated prevalences of overweight were significantly higher with the NHANES II standard compared with the HHANES cutoff points (P < .05) for Mexican American women (43% vs 29%) and Puerto Rican women (40% vs 28%). They were slightly lower for the Cuban American women (36% vs 39%). Cutoff points are relative, not absolute, standards that must have biologic meaning. Before our results are used for assessing populations, the cutoff points should be tested for predictive validity with chronic disease rates.


Determinants of weight gain in pregnant adolescents.

Maternal weight gain is the most important modifiable determinant of infant birth weight. Effective intervention requires an understanding of the factors that influence the amount of weight women gain during pregnancy. We studied the dietary, health, and social habits of 141 poor, black, 12- to 19-year-old prenatal patients to learn more about the determinants of weight gain among pregnant adolescents. The patients were divided into three weight gain groups: slow (n = 23): less than 0.28 kg/week; average (n = 87): 0.28-0.45 kg/week; and rapid (n = 31): more than 0.45 kg/week. The results of logistic regression analysis revealed two statistically significant predictors of slow weight gain: the consumption of fewer than three snacks per day and delayed (third trimester) enrollment in the Supplemental Food Program for Women, Infants, and Children. By contrast, rapid gainers were more compliant with prenatal visits and reported more depressive symptoms and alcohol consumption than did other study subjects. We conclude that attention to these modifiable correlates of inadequate and excessive weight gain may enable dietitians and other health care providers to develop more effective strategies for promoting optimal weight gain among pregnant adolescents.


Demographic and economic factors associated with dietary quality for adults in the 1987-88 Nationwide Food Consumption Survey.

Data for 5,884 adults (19 years of age and older) who participated in the 1987-88 Nationwide Food Consumption Survey (1987-88 NFCS) were used to investigate demographic and economic factors associated with dietary quality. Although the low response rate for the 1987-88 NFCS has raised concerns about possible bias, it is appropriate to use this extensive data set for analyses that do not attempt to generalize the results to the US population as a whole. Two aspects of quality were calculated for the mean of the 3-day reported intakes: number of nutrients below two thirds of the 1989 Recommended Dietary Allowance (RDA) (low-intake nutrients) and percent of energy from fat. Few adults reported mean intakes that met suggested guidelines: 22% of diets were above two thirds of the RDA for all 15 nutrients and 14% were below 30% fat, but only 2% met both criteria. Energy intake was a strong negative predictor of number of low-intake nutrients and a weak positive predictor of percent of energy from fat. Results of multivariate regression analyses identified few demographic or economic predictors of either the number of low-intake nutrients or percent of energy from fat. According to these data, diets of most adults do not conform to current dietary guidelines. Nutrition education efforts should be directed to all adults, and research should be undertaken to determine more effective ways to help adults improve their overall dietary quality.


Development and preparation of lean meat products.

When the effect of food on human lipoprotein levels is tested, or when human consumption of dietary lipids must be controlled or limited, all food needs to be provided under controlled conditions to achieve consistent composition and sensory traits. It is especially important to control the composition of foods, particularly fat and fatty acid content. Because of the inherent biologic variability in the chemical composition of animal tissues (beef in particular), raw materials must be selected carefully and prepared under strict guidelines. In addition, chemical composition should be verified initially and during the production of the product to ensure the accuracy necessary for controlled dietary intake. Furthermore, the meat provided must be easy for the study subject to prepare, be of consistent serving size, and yet be highly palatable to maintain the subject's interest and participation. This article outlines the protocol for developing lean meat products for use in nutrition studies in which fat content must be controlled, especially those studies designed to examine the effect of fat content on human lipoproteins. Preliminary studies, procurement of raw materials, procedures for recipe selection, product preparation, and sampling procedures for verification of chemical composition are described. Our findings indicate that fat intake from beef, chicken, and fish can be controlled for use in nutrition studies.


Nutrient composition and sensory attributes of cooked ground beef: effects of fat content, cooking method, and water rinsing.

Ground beef with 10%, 20%, and 30% fat was shaped into patties or crumbled and cooked by panfrying, panbroiling, or microwaving. After cooking, half of the crumbles were water rinsed. Samples were analyzed for yield, energy, moisture, protein, total lipid, cholesterol, iron, and zinc. In other experiments, cooked crumbled samples were analyzed for vitamin B-12 content and sensory qualities. Effects of cooking method on total lipid and cholesterol levels were generally small. Initial fat level significantly affected total lipid content in cooked ground beef; cooked samples with 10% initial fat contained slightly less total lipid than those with 20% or 30% initial fat. Rinsing with warm water significantly reduced fat and increased the moisture content of cooked ground beef crumbles. Protein, iron, zinc, and vitamin B-12 were well retained during rinsing. We conclude that consumers can achieve a significant reduction in fat content, without substantial losses in protein, iron, zinc, or vitamin B-12, if they water rinse cooked ground beef crumbles. The flavor and texture of the cooked ground beef crumbles are altered somewhat by rinsing. Acceptance in mixed recipes was not determined.


Consumption of a dehydrated ration for 31 days at moderate altitudes: status of zinc, copper, and vitamin B-6.

Intake of energy zinc, copper, and vitamin B-6 and indexes of zinc, copper and vitamin B-6 status were determined for eight men who consumed a high-carbohydrate dehydrated ration for 31 days of high activity at moderate altitudes (2,400 to 4,300 m). Data were collected 2 months before exposure (PRE), four times during the month at moderate altitudes (ALT), and 1 month after return (RET). Mean (+/- standard error) energy intake was 2,725 +/- 215, 3,430 +/- 79, and 3,370 +/- 215 kcal/day during PRE, ALT, and RET, respectively. Zinc and copper intakes averaged 10.6 +/- 1.6 and 1.0 +/- 0.1 mg/day during PRE and increased significantly to 16.9 +/- 0.7 and 3.5 +/- 0.1 mg/day during ALT; zinc and copper intakes were 15.5 +/- 1.6 and 1.9 +/- 0.3 mg/day for RET, respectively. Similarly, vitamin B-6 intake was significantly higher during ALT (PRE = 2.2 +/- 0.5 mg/day; ALT = 4.2 +/- 0.4 mg/day; and RET = 2.6 +/- 0.4 mg/day) as compared with PRE and RET. No significant changes were noted for plasma zinc, copper, or their related proteins or plasma or erythrocyte pyridoxal-5'-phosphate. Finally, no changes in urinary excretion of zinc were observed. The results indicate that dehydrated rations provide zinc, copper, and vitamin B-6 in amounts above the Recommended Dietary Allowances. Such diets may be consumed for at least 1 month without compromising status for these nutrients.


Participation in a worksite cholesterol education program in a university setting.

Three hundred ninety-six employees of a large northeastern university participated in a blood cholesterol screening and provided follow-up data about their participation in a videotape cholesterol education program. Ten percent of these employees watched the videotape program; these individuals were significantly more likely to be at high risk for cardiovascular disease than were persons who chose not to watch the videotape. Persons participating in the cholesterol education program significantly increased their nutrition knowledge and significantly decreased their fat intake compared with nonparticipants. The most important reason given for watching the videotape was "concern about my cholesterol level." Reasons given for not watching the videotape were that it was "not well advertised" or that it was shown "at an inconvenient time." Although all 98 employees at high risk for cardiovascular disease were referred to their physicians for diagnostic evaluation, one third of these employees reported not seeing their physicians. These findings indicate that worksite cholesterol screening and education programs can improve nutrition knowledge and dietary behavior; however, these programs should develop strategies to increase participation and should follow up physician referrals.


Worksite nutrition education can lower total cholesterol levels and promote weight loss among police department employees.

Individuals who work in law enforcement careers are often subjected to stress that can result in health and emotional disorders. Many police departments have begun to offer wellness programs to support their employees. This pilot study designed and implemented a nutrition education component for an existing police department wellness program. Twenty-eight subjects completed the 12-month study that included nutrition counseling, seminars on nutrition and eating behaviors, and monitoring of weight and blood lipid levels. There was a significant group trend for decreased weight and lower total cholesterol levels. Results of the study led to the development of health policy standards for the Austin (Tex) Police Department. Wellness programs that involve registered dietitians can result in weight loss and lower cholesterol levels for employees in high-stress occupations as well as changes in departmental policy.


Reimbursement for clinical nutrition services: a 10-year experience.

Charges for nutrition products and services grew more than 800% between 1980 and 1990 at Children's Memorial Medical Center, Chicago, Ill. Three factors contributed to the growth in charges: distinguishing special services from those included in the bed charge, requiring rigorous documentation of services ordered and provided, and building administrative support for the program. Of the charges, 91% were related to nutrition support. The hospital converted 99% of the charges to private payers into actual revenue. The charge program provides the structure, discipline, and data to demonstrate the value of nutrition services for improving patient outcomes and may help sustain financial support even if the health care industry continues to move away from direct payment for services. Charging for nutrition products and services is a useful way for dietitians to document and be compensated for the value of their services in a hospital setting.


African-American women who always use condoms: attitudes, knowledge about AIDS, and sexual behavior.

Given the alarming increase in the incidence of sexually transmitted diseases (STDs), including AIDS, among African-American women, it is apparent that many people are engaging in sexual intercourse without using condoms. The current study examined the interrelationships among attitudes about condom use, knowledge about AIDS, sexual behavior, and drug use among 121 adult African-American women who varied in their intentions to use condoms: 21 (17%) were classified as Steady Users, 75 (62%) did not use condoms but they had High Intentions to, while 25 (21%) did not use condoms and had Low Intentions to use them. Results indicate that the three groups did not differ in their overall knowledge about AIDS or their attitudes toward using condoms as contraceptives. Significant group differences were noted for other scales that assessed attitudes about condoms. Attitudes about the use of condoms were very similar for the Steady Users and the women in the High Intentions group. However, these two groups were significantly (p < .01) different in their belief that condoms are uncomfortable and interrupt sex. Women with Low Intentions to use condoms had significantly (p < .05) more intense angry reactions regarding the negotiation of condom use and significantly more negative attitudes about the use of condoms than women in the other groups. The three groups were not differentiated by drug use, previous treatment for STDs, or their perceived risk for being exposed to AIDS. The present study is cross-sectional in nature and future research using better methodology is needed to establish causal relationships.


Vision problems at video display terminals: a survey of optometrists.

One thousand three hundred seven optometrists responded (25.3 percent response rate) to a mail questionnaire concerning VDT patients in their practice. On the average, 14.25 percent of optometric patients present with symptoms primarily associated with use of the VDT, or almost 10 million examinations annually when projected to the U.S. population. A majority (55.3 percent) reported that their VDT patients have symptoms that are different than other near point workers, especially as related to glare, lighting, unique viewing conditions and spectacle requirements, and the greater frequency and severity of symptoms. They judged that they were unable to arrive at a confident diagnosis and treatment plan for 20.87 percent of VDT patients, which was significantly more than the 14.05 percent for non-VDT patients. Uncorrected refractive errors, accommodative disorders, irritated eyes, binocular vision disorders, and spectacle design problems were the most frequently cited diagnoses. On the average, 39.3 percent of their VDT patients receive a special VDT prescription or spectacle design that is different than they would require for other daily activities. They judged that 36.8 percent of the symptoms were related to visual environmental factors, primarily glare, lighting, screen resolution and work arrangement. The best way to resolve symptoms for VDT workers is to provide thorough vision examination and treatment in conjunction with diagnosis and treatment of visual environmental problems.


Specialty differentials, limited license practitioners, and Medicare's new fee schedule.

The use of specialty differentials in the newly adopted Medicare fee schedule has been debated over the past 2 years. Arguments supporting the elimination of specialty differentials for optometrists and ophthalmologists are presented. The first recommendations by the Physician Payment Review Commission eliminating specialty differentials represent a victory for optometry in its efforts to achieve parity in the reimbursement of Medicare-covered services. Relative value units and practice costs to be used by the new Medicare fee schedule must be determined for optometry. Estimates of the model fee schedules for eye care procedures have been released by the Department of Health and Human Services.


Visuo-spatial discrimination and mirror image letter reversals in reading.

This review compares visuo-spatial and linguistic mechanisms for discriminating between mirror image letters. The conclusion is drawn that both processes play a role in efficient reading, their relative contributions varying with reading experience and ability. It is shown that arguments used to reject visuo-spatial theories in mirror image letter reversals are flawed. Attention is drawn to the importance of visuo-spatial discrimination of mirror image letters, based on confident left/right body awareness, for beginning readers and for older children who are deficient in compensatory linguistic skills. When confused left/right body awareness is found in association with reversal problems, there is an indication to provide remediation that includes the promotion of mirror image letter discrimination based on confident left/right body awareness. Early intervention (pre-school and infants class) programs that teach left/right body awareness as a pre-reading skill are justified when the progress of beginning readers is facilitated and the need for remedial intervention is reduced in later years.


Hormone replacement therapy: decision making in an age of uncertainty.

The burgeoning epidemic of breast cancer has led to further scrutiny of the relationship between it and estrogen replacement therapy. While, according to multiple analyses, the relative risk of breast cancer in estrogen users seems to be only slightly increased over 1.0, the risk is not evenly distributed among various populations of women. In clinical practice, doctors are not certain which of their patients are prone to develop breast cancer and which are not. Still, the physician confronts the need to make practical decisions about hormone administration. A decision tree is presented in this paper to facilitate the choice and to help the practitioner in reconciling two seemingly contradictory medical precepts.


Attitudes about women in optometry.

A survey was conducted to examine attitudes that affect women in optometry. Most respondents felt that women have greater difficulty than men entering private practice. On the other hand, the majority felt that female optometrists do not find it more difficult to be employed by other ODs, MDs, or to work in corporate settings, HMOs/health institutions, or academic settings. Examining the results of the survey can help establish programs of professional development that will enable women to practice in the environments that they find most suitable. In addition, an open and honest discussion of these issues can raise the sensitivity of the optometric community to these issues.


Using the Wayne Saccadic Fixator to evaluate aspects of laterality skills in children.

The Wayne Saccadic Fixator has been used to evaluate various performance characteristics of a subject's eye-hand coordination, visual reaction times, peripheral awareness, and saccadic eye movement skills. The purpose of this investigation was twofold: first, to establish standard performance scores for normal achieving children using the Wayne Saccadic Fixator preprogrammed procedure #3. The procedure was structured to compare the scoring ability of a child's dominant and non-dominant hands. The second purpose was to determine if the instrument could be used to identify children who were diagnosed by other testing methods as having laterality/directionality deficits. The data collected indicated that there was a direct relationship between age and scoring ability on this Wayne Saccadic Fixator task. However, both the normal achieving students and the special education children scored equally well when using either their dominant or non-dominant hand. There appeared to be no significant difference in the mean scoring ability of children with a diagnosed laterality deficit and children with normal laterality/directionality skills.


Visual disorders of higher cortical function.

Following stroke or other causes of brain damage, patients may demonstrate visual disorders of higher cortical function. These defects involve visual attention, oculomotor skills, visuospatial orientation and object recognition. It is important for optometrists to understand these conditions and consider their presence in individuals with persistent visual complaints despite a normal exam, or in patients who fail to respond to magnification in low vision rehabilitation. The diagnosis and management of these higher order visual disturbances are discussed.


Pupillary dilation: an eye-opening problem.

Dilation of the pupil is a procedure with both clinical and legal ramifications. Optometrists must be familiar with the requirements of informed consent, which must be met when utilizing dilation on the 4-8 percent of patients with anterior chamber angles that are narrow enough to cause an angle closure. Optometrists also must recognize those circumstances under which pupillary dilation is necessary, both for symptomatic and asymptomatic patients. The correct drug regimen must be selected, whether it is for "routine" pupillary dilation or for a patient with a condition requiring a special drug regimen. Patients with dilated pupils must be appropriately managed, and failure to warn a patient of common and expected side effects may create liability if the failure to warn is the cause of injury. If complications--such as acute angle closure--occur, the optometrist must be prepared to manage the situation so as to minimize the risk of injury to the patient.


Accommodative response during distance optometric test procedures.

The control of accommodation is an essential requirement during the clinical optometric assessment of distance vision. Accordingly, the aim of the present study was to examine the steady-state accommodative response during a number of conventional clinical procedures carried out at a viewing distance of 6m (20 feet). Accommodation was measured subjectively to Snellen letters using a Hartinger coincidence optometer during distance viewing, simulated retinoscopy and following the introduction of cylindrical and prismatic lenses in 13 visually-normal, young adults. No significant change in the mean accommodative response was induced by any of the techniques described, with subjects exhibiting a lead of accommodation of approximately 0.25D for all conditions. The results demonstrate the robustness of accommodation to apparently substantial changes in stimulus conditions.


Frequency of certain urgent eye problems in an emergency room in Massachusetts.

The frequency and cost of emergency room care for certain ocular problems was surveyed. Superficial eye problems accounted for 2.67 percent of patients reporting to the emergency room, while 0.23 percent reported for penetrating injuries. Of the conditions surveyed, conjunctivitis was the most commonly presenting diagnosis. Abrasions and superficial foreign bodies were the next most common presentations. Together these three diagnoses accounted for nearly 75 percent of all superficial eye problems seen in the emergency room. The cost of each emergency room visit averaged $132. This study has implications for health care managers and for legislatures contemplating expanding the scope of optometric practice.


Penetrating injury from hammering with subtle ocular damage.

Penetrating ocular injuries are usually associated with major disruption of the globe and vision loss. On occasion, the signs and symptoms accompanying an intraocular foreign body can be subtle. Such a case is presented in this paper and hammer injuries as a cause of penetrating ocular injury are reviewed.


Health care rationing in the United States: are we there yet?

Given the skyrocketing costs of health care in the United States, some experts propose official health care rationing as a solution to the crisis. Others maintain the position that health care is already being rationed because of cost, and always has been. This paper presents evidence supporting both viewpoints and, by exploring two definitions of "rationing," shows that they are not mutually exclusive. Practical applications to optometry as a health profession are mentioned.


Increased occurrence of exfoliation in the male, Spanish American population of New Mexico.

Exfoliation syndrome was found to occur much more frequently in the male Spanish American population of New Mexico. This was based on a Veterans Administration Medical Center study in Albuquerque, New Mexico. The prevalence of exfoliation in the Spanish Americans was estimated to be from 3-6 percent and this is consistent with many other such studies performed in the United States and other countries. The Spanish American population is 5.8 times more likely to develop exfoliation than the non-Spanish American population of New Mexico. Exfoliation was found on such eye structures as the lens, iris, ciliary processes, posterior capsule, vitreous face, posterior corneal surface, and arterial chamber angle. Glaucoma capsulare was also studied and it was found that there was not a significant difference between the Spanish American and the non-Spanish American population for developing the condition. However, there was a strong association of glaucoma with the presence of exfoliation in both groups. Based on our results, patients with exfoliation are 22 times more likely to develop glaucoma than are their age-matched controls. Also, 40 percent of the exfoliation patients had glaucoma compared with only 5 percent of the age-matched controls (p less than .001). The patients with glaucoma capsulare were found to have a more medically resistant type of glaucoma, which was consistent with other reports of this condition. There are two theories we propose for the existence of exfoliation in the Spanish American population of New Mexico. The first is a geographic climatic theory that relates exfoliation to greater solar radiation levels due to a high overall altitude and sunny weather in New Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)


Aiding the novice practitioner in contact lens selection.

A comprehensive study was performed to assist the new graduate and novice contact lens practitioner in the choice of the optimal lens for each case scenario, as well as provide guidance for inventory selection. The survey was distributed to the clinical staff at the State University of New York, State College of Optometry, in order to take advantage of the knowledge of the experienced contact lens fitter. There appear to be clinically significant relationships between lens characteristics and performance ratings.


Paranoid character and the intolerance of indifference.

This paper suggests that aspects of paranoid character are structured around fantasies of magical and concrete connectedness to objects; these fantasies serve to avoid the terrors of object inconstancy. The authors describe how these fantasies are expressed in the psychoanalytic situation and explore their relation to common paranoid phenomena. The paranoid person must maintain these fantasies of connectedness at all cost or risk experiencing unbearable indifference between self and object. Paradoxically, the sacrifice of self and object boundaries inherent in these fantasies makes object constancy even more difficult to achieve because of the secondary defensive use of anger mobilized to protect the boundaries of the self.


Psychoanalytic theory and its relation to clinical work.

Freud's shift to the fantasy theory of neurosogenesis defined the investigation of intrapsychic life as our fundamental theoretical purview. In assigning to inner experience a data base for scientific exploration, there is reflected a central epistemological innovation which must profoundly alter the way we view what is real. This paper considers some of the continuing clinical challenges and far-reaching implications posed by this shift to "psychic reality" as our core psychoanalytic theory.


The concept of the therapeutic alliance.

Certain conceptual aspects of the therapeutic alliance are considered. Although therapeutic alliance, transference, and the real relation are intermingled and intertwined in the actuality of the analytic relationship, they remain distinguishable and open to differentiating analysis. The distinctions between the therapeutic alliance and transference, and between alliance and the real relation, are explored and their differences clarified, including the difference between therapeutic misalliances and transferences. Some of the component dimensions of the therapeutic alliance are explored, including empathy, the therapeutic framework, responsibility, authority, freedom, trust, autonomy, initiative, and ethical considerations including values and confidentiality. Further exploration of these and other dimensions of the therapeutic alliance is called for, especially the extension of these dimensions to their practical clinical application.


Recurring thoughts on unconscious ego resistances.

Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.


The absence of the father.

The author discusses the role of the father in early development through the concept of triangulation. Three male patients are presented who seemed to lack images and memories of their fathers and experienced them as absent, despite their physical presence during childhood. In these men, the oedipal phase appeared skewed and a dyadic relationship with the mother dominated the material. They reported a lack of a sense of masculinity and a phobic concern about the dangers of male violence, along with feelings of specialness and grandiosity. Analytic data suggested that the image of an absent father reflected a process akin to splitting of the ego, in which the significance of the father was disavowed and the patients fantasized a special role with their mothers; via projection, the fathers reappeared as dangerous intruders. It is proposed that this structure derives from a specific developmental situation in which a disturbed parental relationship has impaired the father's position as a "third" in the early triangle. The child's sexual and aggressive tensions cannot be contained in his fantasies of the couple and must be projected outside. The absent father returns in the transference, where the analyst is reexperienced as useless and absent and as a threat to the specialness of the dyad, thereby recapitulating the predicament of the child.


Connectivity and condensation in dreaming.

Converging developments in the cognitive- and neurosciences have brought Freud's hope of a bridge between psychoanalysis and psychophysiology nearer to hand. This paper concerns the relation between dream construction and memory in terms of these new developments. The neural network architecture of memory structures in the brain is described and illustrated with simple examples. We see how a network is connected and how connection weights vary with experience. The distributed representation stored by the network and its crucial properties for mental functioning are discussed. These concepts are used to explain how particular memories of past events are selected for inclusion in the dream. The properties of the neural network suggest that images of distinct past events are conflated at times during the selection process. The appearance of these conflated images may complicate the matching of day residues with representations of past events in the dream itself. Some likely implications for psychoanalytic theory are explored.


Acting up and physical illness: temporal patterns and emerging structure.

Many psychoanalytic writers have viewed acting out and somatization as alternate routes for the discharge of uncontained aggressive impulses in borderline patients. In order to investigate this empirically, we tracked the occurrence of two related behaviors--acting up and physical illness--over the course of one patient's long-term hospitalization. Daily scores on these variables were analyzed using a time series procedure. Results indicated that as treatment progressed, acting up and physical illness became more synchronized, and this occurred just prior to symptom remission. Material from psychotherapy suggested that these behavioral changes were associated with the patient's increased ability to verbalize aggressive impulses in the context of fantasy and memory.


Psychoanalytic training today.

Psychoanalytic education in the United States faces multiple challenges as we enter the last decade of this century. (1) Changing interest and career path patterns for psychiatrists have resulted in fewer medical applications for psychoanalytic training. (2) Increased opportunities for full psychoanalytic training of nonphysicians have resulted in increased applications from highly skilled clinicians who often have more clinical experience than their medical colleagues. (3) Increased enrollment of women candidates has required rethinking of progression requirements, in light of their combined careers as professionals and mothers. (4) Independent institutes not accredited by the American Psychoanalytic Association compete for applicants while maintaining training standards that require less time and immersion in psychoanalytic theory and practice. (5) Economic factors increasingly influence the desirability of prolonged psychoanalytic training and the availability of suitable analysands for control analyses. (6) Evolution of theory and practice and the emergence of "new schools" of psychoanalytic thought have rendered the previous psychoanalytic landscape dominated by drive theory and ego psychology more multifaceted and less uniform. The American Psychoanalytic Association and its institutes attempt to understand these changing patterns and take them into consideration in the design and implementation of psychoanalytic training programs. Only one aspect of this complex situation will be described in this work, the current state of psychoanalytic training in the 28 institutes accredited by the American Psychoanalytic Association. Although the data available at this time leave unanswered many important questions about the philosophies that organize the content and emphases of the curriculum in different institutes, much has been learned about the overall structure of psychoanalytic training programs.


"Incest--see under Oedipus complex": the history of an error in psychoanalysis.

This paper is intended as a contribution to the understanding of errors in our field. The title refers to the index entries "incest" in several classic psychoanalytic texts. In a way that is analogous to the defenses utilized by survivors of incest, psychoanalysis has both known and not known, avowed and disavowed, the traumatic impact of actual incest. It is argued that psychoanalysis erred in (a) focusing too heavily on the implications of incest for the Oedipus complex instead of its implications for every stage of development, and (b) missing out on the full and detailed description of the clinical pictures of incest victims and of treatment issues, including transference and countertransference. The author presents an overview of the history prompted by Masson's original attack on Freud for abandoning the "seduction hypothesis." Topics covered are: Freud's early papers, the Freud-Ferenczi controversy (1932), and the state of psychoanalytic awareness in the 1960's of the importance of actual incest. Certain features of our field make it all too likely that new errors can be generated that may similarly take decades to recognize and undo. These include the politics of our discipline, and negative attitudes toward systematic gathering and assessment of evidence.


Neutrality, interpretation, and therapeutic intent.

Neutrality is a central concept within the theory of psychoanalytic technique. We spell out the major controversies in which the concept has become embroiled, and provide a definition that we believe coincides with actual psychoanalytic practice. We discuss its merits and weaknesses, noting also the negative consequences of relying on older definitions. We relate neutrality to the interpretive process, indicating ways interpretation protects neutrality and is made more effective by it. We discuss the complex and controversial relation between neutrality and the analyst's therapeutic intent.


In vivo evaluation of airway and pulmonary tissue response to inhaled methacholine in the rat.

The current study was designed to assess the methacholine dose-response behaviour of the airways and pulmonary parenchyma with the aid of alveolar capsules. The experiments were performed in eight adult female Wistar rats (155-250 g). The animals were anaesthetized with sodium pentobarbital (30 mg kg-1 i.p.) and mechanically ventilated. Measurements of tracheal (ptr) and alveolar (pA) pressures and the pressure change across the airway (p(aw)) were performed prior to and after exposing rats to aerosols generated from sequentially increasing concentrations of methacholine chloride solution (2, 4, 8, 16, 32, 64 and 128 mg ml-1) through the breathing circuit. Baseline p(aw) and pA mean (+/- SD) values (6.44 +/- 2.06 and 8.25 +/- 3.44 cmH2O, respectively) were not statistically different (P = 0.220). The increases in ptr and pA were significant during the dose-response study (P = 0.001), whereas p(aw) was not increased. The increase in pA was significantly higher than that of p(aw) (P less than 0.001). The relationship between the mean (+/- SE) values of ptr and pA could be well described by a straight line (r = 0.990, P less than 0.001). There were also significant correlations based on regression equations between ptr and p(aw) (r = 0.947, P less than 0.001) and pA and p(aw) (r = 0.913, P = 0.004). These findings suggest that the pulmonary tissue of rats is a major component responsible for the increase in lung impedance observed after methacholine challenge. In addition, airway and pulmonary parenchyma pressure changes were correlated, suggesting that both lung regions have a similar sensitivity to the agonist. Our results indicate that the response of peripheral tissues should be considered during bronchial challenge protocols in rats.


Toxicology of carbaryl and aldicarb on brain and limb cultures of chick embryos.

A variety of carbamates have been developed since the 1960s for use as broad-spectrum insecticides. An easy and inexpensive in vitro assay using chick-embryo derived cells was examined for its capability to screen and test the toxicity of these compounds. Chick embryo brain and limb bud cultures were treated with different concentrations of either carbaryl or aldicarb with or without activation (+/- S-9) for 5 days. Viability and cytotoxicity using the neutral red assay, and carbamate effects on cell migration and colony spread were measured. S-9 decreased the effects of carbaryl and aldicarb on brain cell cytotoxicity at exposures of 15-60 ppm and 40-200 ppm, respectively, as indicated by increased concentrations of neutral red. Viability of brain cell cultures was not altered by aldicarb, but was decreased by carbaryl plus S-9 in concentrations of greater than 40 ppm. In limb cultures, carbaryl without S-9 was significantly toxic at 8-25 ppm, but only concentrations of greater than 25 ppm of carbaryl plus S-9 significantly affected cytotoxicity. In contrast, aldicarb without S-9 caused no effect on limb cell cytotoxicity at concentrations of 40-200 ppm, but aldicarb plus S-9 significantly reduced cellular cytotoxicity at concentrations of greater than 160 ppm. Carbaryl +/- S-9 decreased the spread of both brain and limb colonies; aldicarb +/- S-9 caused a significant increase in the spread of the brain but not limb colonies.(ABSTRACT TRUNCATED AT 250 WORDS)


The effect of a commercial 2,4-D formulation on chemical- and viral-induced tumor production in mice.

Male CD-1 mice were exposed to a commercial formulation of 2,4-dichlorophenoxyacetic acid (2,4-D), the amine derivative, in the drinking water at concentrations ranging from 0 to 0.163% of the formulated product, equivalent to approximately 0-50 mg kg-1 day-1 2,4-D content. The effect of 2,4-D on urethan-induced pulmonary adenoma formation was evaluated following a 105-day exposure. Urethan-induced sleeping times observed following an i.p. injection of urethan (1.5 mg g-1) after 3 weeks of 2,4-D exposure were not altered by 2,4-D, indicating that 2,4-D did not influence urethan elimination. Pulmonary adenoma production, which was evaluated 84 days after urethan injection, was enhanced by 2,4-D exposure but had no effect on tumor size. The effect of 2,4-D on the incidence of spontaneous murine lymphocytic leukemia was evaluated during the 365-day treatment period. Mortality associated with the leukemia virus was not altered by 2,4-D treatment. Exposure to this commercial 2,4-D product at moderately high levels of exposure may modify the development or expression of certain tumors in CD-1 mice. The mechanism of the co-carcinogenic or tumor-promoting activity associated with 2,4-D exposure remains to be determined.


Incidence of residual levels of organophosphorus insecticides in farm produce in the Region of Murcia, Spain. Comparison of intake in the 1985-86 and 1989 campaigns.

We calculated the effective dietary exposure to 20 organophosphorus insecticides in a sample of residents of the Region of Murcia (Spain). Calculations were based on the contamination of 2310 specimens of citrus fruits, pitted and seedy fruits and vegetables collected in the 1985-86 and 1989 campaigns. A comparison of the results from the two campaigns showed that the mean annual insecticide ingestion determined from the mean consumption of each type of farm produce fell from 7.82 mg to 5.55 mg over the 4-year period studied. The total annual ingestion of insecticides during the 1985-86 and 1989 campaigns was ca. 0.133 and 0.1 mg kg-1 body weight; these values are well below the admissible annual ingestion of 29.565 mg kg-1 body weight.


Development and validation of a high-performance liquid chromatographic method for the determination of benzophenone-3 in rats.

A precise, accurate, selective and sensitive liquid chromatographic method for the determination of benzophenone-3 in rat biological fluids and different tissues has been developed. The minimum detection limit for benzophenone-3 was 2.0 ng ml-1 and the retention time was 6.01 min. Standard curves for benzophenone-3 were linear in a wide range of concentrations in methanol and different body fluids, ranging from 6.25 ng ml-1 to 100 micrograms ml-1. To detect benzophenone-3 in rat whole blood after oral administration, HCl hydrolysis was required. Benzophenone-3 was found to produce a peak blood concentration 1 h after administration. Free benzophenone-3 in urine represented a very small percentage during the first 12 h after administration, while a higher concentration of the glucuronide conjugate was detected in the same time period.


Mutagenicity studies on two triphenylmethane dyes, bromophenol blue and tetrabromophenol blue.

Bromophenol blue and tetrabromophenol blue are two triphenylmethane dyes. Triphenylmethane derivatives and their structurally related compounds, such as fluoresceins and xathenes, are widely used as industrial dyes for foods, drugs, cosmetics, textiles, printing inks or laboratory indicators. Since a number of these types of dyes have been reported to be genotoxic, safety concerns on these two dyes of interest have been raised. Consequently, a battery of genetic toxicology assays, including the Ames Salmonella/microsome assay, L5178Y TK+/- mouse lymphoma assay, mouse micronucleus test and mitotic recombination assay with yeast Saccharomyces cerevisiae strain D5, has been performed on each of the two dyes. The results of the evaluations indicate that both bromophenol blue and tetrabromophenol blue were not active and can be considered non-genotoxic for the three genetic endpoints assessed (gene mutation, chromosome aberrations and primary DNA damage). Genetic activities in some structurally related compounds of these dyes have been reported but may be attributed to the presence of mutagenic impurities rather than the compound itself.


The influence of fenarimol on DNA synthesis and mitotic activity in rat liver.

Fenarimol administered in one single oral dose of 125 or 62.5 mg kg-1 body wt. day-1, respectively, stimulated rat liver enlargement at a dose-independent rate. Three single doses of fenarimol produced dose-dependent liver growth, whereas five single doses caused no further increase in liver weight. This increase was accompanied by an increase in hepatic DNA synthesis and mitotic activity, with a peak on the first day after the beginning of the experiments. The increase in binuclear hepatocytes and signs of necrosis suggested that the hepatomitogenic effect reflected a compensatory hyperplasia. After both three and five single doses the hepatomitogenic effect was suppressed, as a result of tolerance development.


Relationship between eye and skin irritation in rabbits using a series of textile fiber finishes.

A series of 76 fiber finishes, typically composed of blends of lubricants, emulsifiers, antistatic agents and fatty acid soaps, were tested in rabbits to determine both the eye and the skin irritation potential. Each finish was classified as being either non-, slightly, mildly, moderately or severely irritating to the target tissue during a 48-h post-treatment period. Seven (9.2%) of the finishes tested were severely irritating to both the skin and the eye; two (2.6%) were determined to be non-irritating to both tissues. While occasionally finishes produced equal degrees of damage resulting in similar irritancy classifications, seven (9.2%) finishes were found to be severely irritating to the skin without producing any irritation in the eye. Conversely, one finish was found to be a severe eye irritant without producing any skin irritation. The suggested use of the skin irritation data to predict the ocular reaction needs to be carefully examined, particularly with materials such as these fiber finishes. The prediction that a severe skin irritant is also a severe eye irritant was demonstrated to be in error with 8 of 75 (10.5%) of the finishes studied. Further, there is little predictive association between the skin and eye irritation for these compounds.


Effects of nickel hydroxycarbonate on alveolar macrophage functions.

The metabolic effects of different concentrations of nickel hydroxycarbonate (NiHC) on guinea pig alveolar macrophages (GPAMs) were investigated. Exposure to high concentrations of NiHC (6.25 and 12.5 micrograms 10(-6) cells) led to cell vacuolization. Morphological changes were associated with a dramatic reduction in the steady-state level of cellular adenosine triphosphate (ATP), i.e. ATP levels were reduced by 35% (P less than 0.001) and 53% (P less than 0.01), respectively. Low concentrations of NiHC (0.0625 and 0.125 microgram 10(-6) cells) did not induce morphological changes but increased cellular ATP content by 19% (P less than 0.01) and 12% (P less than 0.05), respectively. Effects of NiHC (0.125 and 6.25 micrograms 10(-6) cells) on cell oxidative metabolism were studied. The chemiluminescence was significantly increased (P less than 0.001) by the lower but not the higher concentration. A slight inhibition of total superoxide dismutase (P less than 0.05) and a decrease of catalase activity were demonstrated (P less than 0.05) for the high dose, while the low dose decreased the levels of reduced and total glutathione. In conclusion, the effects of NiHC on alveolar macrophages are characterized by an overproduction of free radicals for low concentrations and the depletion of cellular reserve energy, particularly ATP, for high concentrations.


Preliminary report on the use of zinc in vivo to protect against nitrogen mustard toxicity in female Balb/cJ mice.

Previous studies with cultured normal human fibroblasts indicated that treatment of cells with zinc before exposure to an alkylating agent enhanced cell survival by seven- to ninefold. To establish whether a similar zinc-induced protective response could be elicited in vivo, we conducted a preliminary experiment in which Balb/cJ female mice were treated with zinc (2 mg kg-1 body weight) or saline by intraperitoneal (i.p.) injection at 48, 36, 24 and 12 h before i.p. administration of the alkylating agent nitrogen mustard (4 mg kg-1 body weight). Of the animals that received saline before nitrogen mustard, 57% died as compared with only 20% in the group treated with zinc before administration of the alkylating agent. As was observed in the studies of cells in culture, the results described in this report may suggest the existence in Balb/cJ female mice of a zinc-mediated protective response against nitrogen mustard toxicity.


Attempted use of zinc in vivo to protect against nitrogen mustard toxicity in tumor-free and in L1210 leukemia-bearing female B6D2F1 mice.

The use of alkylating agents in treating cancer is limited by their toxicity to both normal and tumor tissue. Early in vitro studies indicated that zinc might be effective in mitigating this toxicity to normal tissue. The present studies were done to determine the capability of zinc to induce in vivo a protective response to an alkylating agent without also contributing to mortality. Tumor-free and L1210 leukemia-bearing female B6D2F1 mice were treated with zinc before administration of the alkylating agent nitrogen mustard. Protocols for administration route and frequency as well as the chemical formulation of the zinc were varied. The effect of a phytate-free diet was studied. Two parameters were used to determine the effectiveness of zinc in protecting animals from the toxicity of nitrogen mustard: the number of tumor-free mice that survived and an increase in the median life span of the tumor-bearing mice. The zinc-induction protocols used in these studies provided a limited degree of protection against nitrogen mustard toxicity in tumor-free female mice, but in tumor-bearing animals the protective response elicited with the protocols examined did not provide an appreciable therapeutic benefit.


A novel non-radioactive method for detection of nucleoside analog phosphorylation by 5'-nucleotidase.

Cytosolic 5'-nucleotidase has been implicated in the phosphorylation of certain nucleosides of therapeutic interest. In vitro, IMP and GMP serve as the optimal phosphate donors for this nucleoside phosphotransferase reaction. Existing assays for nucleoside phosphorylation effected by 5'-nucleotidase require a radiolabeled nucleoside as the phosphate acceptor and separation of the substrate-nucleoside from product-nucleotide has been accomplished either by a filter binding method or HPLC. However, detection of the phosphorylation of unlabeled nucleoside by HPLC is difficult since the ultraviolet absorbance of the phosphate donor, IMP, frequently obscures the absorbance of newly formed nucleotide. The use of ribavirin 5'-phosphate (RMP, 1,2,4-triazole-3-carboxamide riboside 5-monophosphate) as the phosphate donor obviates this difficulty since this triazole heterocycle does not significantly absorb at the wavelengths used to detect most nucleoside analogs. Using this procedure, a 5'-nucleotidase activity from the 100,000 x g supernatant fraction of human T-lymphoblasts deficient in adenosine kinase, hypoxanthine-guanine phosphoribosyltransferase, and deoxycytidine kinase, was characterized with regard to structure-activity relationships for certain inosine and guanosine analogs.


A simple assay for determination of iron release from ferritin in neuroblastoma cells.

A commercially available enzyme immunoassay was used to determine ferritin content and subsequently the loading and release of iron from ferritin in neuroblastoma cells. LS cells were incubated with 59Fe for 24 h, lysed, and the cytoplasmic ferritin was bound to monoclonal antibodies coupled to globules. After determination of the ferritin content the same globules with bound radioactive ferritin were measured in a gamma-counter. To illustrate the applicability of this test system, increased iron loading of cellular ferritin could be demonstrated in cycloheximide-treated cells; furthermore, release of iron was documented after incubation of LS cells with a combination of 6-hydroxydopamine and ascorbate. The assay turned out to be a simple method for determination of changes in 59Fe content of ferritin in neuroblastoma cells.


Assay of intracellular thymidylate synthetase activity and inhibition by 5-fluoro-2'-deoxyuridine in lymphocytes.

Thymidylate synthetase catalyses the formation of thymidine monophosphate from deoxyuridine monophosphate. Purified thymidylate synthetase can be assayed radiochemically using labelled deoxyuridine monophosphate as substrate, but cells are impervious to deoxyuridine monophosphate and so intracellular thymidylate synthetase activity cannot be assayed in this way. In this paper we describe the assay of intracellular thymidylate synthetase activity in intact cells using labelled 2'-deoxyuridine. The assay showed linear kinetics with respect to time, concentration of 2'-deoxyuridine, and cell concentration. 5-fluoro-2'-deoxyuridine inhibited intracellular thymidylate synthetase activity measured with this assay by 50% at 5 nM. Cell growth was inhibited by 50% at 6 nM 5-fluoro-2'-deoxyuridine. The assay was specific for thymidylate synthetase and enabled measurement of thymidylate synthetase activity in situ in intact cells.


Establishment of a multi-dose study of chondroitin sulfate iron colloid for evaluation of the reticuloendothelial system function.

The assay system of chondroitin sulfate iron colloid (CSFe) was established to evaluate the reticuloendothelial system (RES) function in individual rabbits. In the multi-dose study of CSFe, CSFe was repeatedly administered to each individual rabbit with increasing doses (0.6, 1.2, 2.4, 6.0 mg/kg) at set intervals. Blood samples were serially collected after injection of CSFe and the concentration of CSFe in serum was directly measured as an iron concentration by modifying the previously described assay method [1] to minimize the sample volume. The clearance rate of CSFe at each injected dose was computed by the least-squares method and the double-reciprocal plotting of the doses against the phagocytic velocities by the Lineweaver-Burk method was obtained in each rabbit. The maximum phagocytic velocity (Vmax) and the CSFe concentration producing 1/2 Vmax (Kp) obtained in ten rabbits were 0.129 +/- 0.025 mg/kg per min and 0.417 +/- 0.121 mg/kg (mean +/- S.D.), respectively. The results obtained from this multi-dose study were comparable to our previous results obtained from the mean values of five groups given different doses [1]. The clearance rates of CSFe (0.6, 1.2, 6 mg/kg) decreased after the co-injection of 80 mg/kg of carbon colloid. The calculated Vmax and Kp in 29 rabbits were 0.125 mg/kg per min and 1.167 mg/kg. The Kp was apparently greater than that of the control (Vmax = 0.128 mg/kg per min, Kp = 0.421 mg/kg). Carbon colloid (80 mg/kg) was injected to six rabbits after the completion of the first multi-dose study of CSFe and then the second multi-dose study of CSFe was repeated after 24 h. No differences were found in Vmax and Kp between the two studies as were in the control group (10 rabbits) where saline was injected instead of carbon colloid. These results indicated that carbon colloid (80 mg/kg) gives a competitive and reversible inhibition on the RES. This multi-dose study of CSFe may be applicable for a bed-side analysis of the RES function in a patient.


Development of an antibody against a 170-kDa fragment of fibroin isolated from cocoon fibres of Bombyx mori.

A simple method for the isolation of denatured fragments of the fibroin protein from cocoon fibres by alkali solubilization is discussed. This 170-kDa antigen has been purified and used to raise the polyclonal antibody in rabbit. The specificity of this antibody to the purified cocoon protein has suggested strong immunoreactivity up to a titre of 1:5000 dilution of the antibody. Further, dot-blot analysis with the tissue extracts from silk glands of different larval stages (3rd to 5th) reveals that this antibody reacts showing a stage-specific increase in the intensity of the colour, correlating well with the in-vivo expression of the silk protein. This study suggests the availability of a specific polyclonal antibody that detects the native fibroin with no crossreactivity with other tissue proteins.


A new micromethod for mechano-chemical research.

A new micromethod to study activity of enzymes in crystalline and amorphous solid samples subjected to tension is described. Both static (up to 200%) and dynamic (with an amplitude up to 50% and frequency of 10(-3)-50 Hz) deformation may be applied to the sample during the activity measurement. Strain-induced changes in activity of thin (3-10 microns) needle-like strips (0.2-0.5 microns long), cut out of the microtome sections of cross-linked crystals of pancreatic carboxypeptidase A is measured in a droplet of substrate solution (with volume of 10(-6)-10(-9) l) with a pH-microelectrode technique.


Characterization of immobiline membranes for application in a multicompartment electrolyzer for protein purification.

The efficient use of preparative protein purification in a multicompartment electrolyzer with Immobiline membranes depends on the knowledge of membrane characteristics. For that purpose, an experimental investigation of the effects of ionic charges on the membrane characteristics has been carried out through the measurements of membrane swelling and conductance. We also investigated the effects on the electrolyzer behaviour of operating parameters such as the Immobiline concentration and the presence of ion-exchange membranes. Data show that polyacrylamide gel degree of swelling is strongly dependent upon the pH and the ionic strength of the bathing solution as well as on the type and molarity of charges incorporated in the gel. The conductance of supported Immobiline gels in contact with uni-univalent chloride solutions has been measured by means of a mercury cell. The membrane conductance is also influenced by the ionic strength of the equilibrium solution and the presence of weak ionizable groups in the gel matrix. This study has demonstrated the close link between electrochemical and electromechanical properties of Immobiline membranes.


Decreased Coomassie brilliant blue colour yield with glycated proteins.

Collagen, myosin and albumin were incubated for 7 days at 20 degrees C with fructose, ribose or glyceraldehyde. For thus-formed glycated proteins, quantities were determined by the Conway microdiffusion technique and by the colorimetric method based on Coomassie brilliant blue G-250 colour yield. It was found that when albumin was glycated with increasing amounts of glyceraldehyde, the colour yield was decreased by 7-33%. In collagen, myosin and albumin incubated with 0.5 mol/l fructose, 0.5 mol/l ribose or 0.1 mol/l glyceraldehyde, protein concentration was not changed, as proved by the Conway microdiffusion technique; the Coomassie brilliant blue G-250 colour yield was up to 50% lower, depending on the protein used, and was decreased much less when proteins were incubated with less sugar.


Effect of chemical sympathectomy on scintigraphic gastric and small bowel transit in the rat.

Our aims were to measure gastric and small bowel transit of radiolabeled chow or liquids in rats and to assess the effect of pharmacologically induced chronic sympathectomy of at least 5 weeks duration. Three series of experiments were performed. In series I, four rats in each group underwent i.p. chloral hydrate anesthesia, tracheostomy with intubation and mechanical ventilation: they received by gavage 1.0 g rat chow dissolved in 1.5 ml saline labeled with 1.0 mCi 99mTc-DTPA In series II, four rats in each group were anesthetized with only i.p. chloral hydrate and received 1.5 ml labeled saline. Rats were placed on a gamma camera for dynamic acquisition of 1-min images for 7 h in series I, and 4 h in series II. Activity was quantitated in stomach and cecum; gastric emptying was analyzed by the power exponential model. In series III, four rats in each group were studied for 1 h on gamma camera and sacrificed after 5 h. At the end of each study, the stomach, small bowel, cecum and colon were removed and radioactivity counted in each organ in a dose calibrator. Quantitation of radioactivity by gamma camera was highly accurate: labeled chow in the stomach at 7 h was identical by external camera and counting of the excised organ (linear regression slope = 1.01, r = 0.97, P less than 0.0001). Similar precision was observed with labeled liquids (slope = 0.93, r = 0.93, P = 0.001). Chow emptied slower than liquid in both groups (P = 0.048). Ileocecal movement of isotope occurred by bolus transfers.(ABSTRACT TRUNCATED AT 250 WORDS)


Structure of autonomic neuromuscular junctions in the sinus venosus of the toad.

The structure of cholinergic and adrenergic neuromuscular junctions in the sinus venosus of the toad, Bufo marinus, was determined by electron microscopy. From random sections of sinus venosus tissue it appeared that there were variable separations between cholinergic or adrenergic varicosities and the nearest sinus venosus muscle cell. However, when the structure of complete cholinergic and adrenergic varicosities was determined by examining serial electron micrographs, virtually all varicosities that lost their covering of Schwann cell were found to form an area of close apposition with an adjacent muscle cell. At the region of close apposition, the neuromuscular cleft was filled with a single layer of basal lamina to give a neuromuscular separation of about 70 nm. Synaptic vesicles within a varicosity were usually found to be concentrated towards the region of close apposition. These observations are discussed in relationship to the idea that when transmission occurs at these neuromuscular junctions the transmitters act on discrete pools of specialized subsynaptic receptors.


Effect of L-threo-3,4-dihydroxyphenylserine on muscle sympathetic nerve activity in humans.

To clarify the effect of L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS), a precursor of norepinephrine (NE), the effect of this drug on microneurographically recorded muscle sympathetic nerve activity (MSA) from the tibial nerve was analyzed in ten healthy male volunteers. A single dose of 600 mg of L-threo-DOPS was orally administered and the effect of this norepinephrine precursor on MSA at resting and at upright standing positions, as well as the MSA responsiveness to head-up tilting was examined by comparing the data obtained after administration of the drug with those obtained under control conditions. The plasma NE levels were determined in two subjects. The results were as follows: (1) resting MSA increased significantly 80 min after administration of L-threo-DOPS and was accompanied by an increase in plasma NE levels; (2) standing MSA when treated with the drug was not significantly different from values obtained under control conditions; and (3) MSA responsiveness to orthostasis was reduced after L-threo-DOPS. We conclude from the activation of MSA by L-threo-DOPS that this drug raised blood pressure not only through an increase in metabolized plasma NE levels, but also through the enhancement of MSA by activation of descending noradrenergic or adrenergic pathways proximal to the recording site of the sympathetic discharge.