[Neuroleukemia in suckling mice].

The whole skull and spinal column were histologically studied in 55 suckling mice (intact and with transplantable leukemia). It was stated that the lesion of the vertebral canal prevailed due to the extensive growth of leukemic infiltrates in the bodies of the vertebra which had incompletely formed cortical plate of the bone tissue. Such age-dependent unfinished formation of the bone marrow tissue may predispose a rapid development of neuroleukemia.


[Bronchopulmonary aspergillosis in leukemia patients].

Among 180 patients with varying leukemias bronchopulmonary aspergillosis was diagnosed in 4 (2.2%). Further development of the methods for the treatment of the main disease in this category of patients permits prognosing a significant rise in the incidence of bronchopulmonary aspergillosis. The character of the clinical course of this infection and the ways for further improvements of its diagnosis in lifetime of leukemia patients have been considered.


[Regulation of fibroblast-like cell proliferation in human bone marrow].

The influence of growth factors (GF) and some other biological active molecules on the human bone marrow fibroblast (HBMF) proliferation was studied in the monolayer system. The proliferation of HBMF, like other connective tissue cells, was serum- and GF-dependent. GF tested (EGF, FGF, insulin) produced both positive and negative effects on HBMF proliferation. It was also shown that phorbol ester, which activates protein kinase C, usually inhibited HBMF proliferation. It has been proposed that this feature of HBMF is the cause of GF bifunctional action. It has been suggested that the ability of GF to inhibit HBMF proliferation in some cases permits one to maintain cellular homeostasis in GF rich human bone marrow. HBMF of different hematological patients were characterized by individual differences in GF sensitivity. This may be secondary to the bone marrow cellular composition. For example, HBMF obtained from the bone marrow rich in total cells or megakaryocytes were more responsive to proliferation stimulating effect of GF.


Thyroxine 5'-monodeiodinase activity in microsomes from isolated hepatocytes of rainbow trout: effects of growth hormone and 3,5,3'-triiodo-L-thyronine.

Rainbow trout hepatocytes isolated by collagenase perfusion were suspended in primary culture for up to 72 hr at 11 degrees and then the microsomal L-thyroxine (T4) 5'-monodeiodinase (5'D) activity was evaluated by 125I- generation from [125I]T4. The 5'D activity and Vmax (level of functional enzyme) and Km (Michaelis-Menten constant) values for microsomes obtained from incubated hepatocytes corresponded to those for microsomes obtained directly from intact livers. HPLC analysis revealed 3,5-[125I]3'-triiodo-L-thyronine (T3) as the only significant 125I-labeled organic product. Hepatocyte survival ( > 90%) and 5'D activity were unaltered by insulin (10(-9) M) in the incubate, but 5'D activity was inhibited by 10% fetal calf serum. Human growth hormone (hGH) at concentrations of 5-250 ng/ml did not increase 5'D activity. These results do not support previous in vivo studies demonstrating hGH-enhanced hepatic 5'D function in trout and indicate that either hGH acts indirectly on the liver to enhance 5'D activity or incubated hepatocytes lose GH responsiveness. However, coincubation of hepatocytes with T3 (15 or 30 nM) for 24 hr inhibited 5'D activity in a dose-dependent manner and induced the production of 3-[125I]3',5'-triiodo-L-thyronine (reverse T3). These data support previous in vivo studies in showing that T3 autoregulates its own hepatic production and show that T3 does so by acting directly on the hepatocyte to modify deiodination pathways.


Differential response of amphibian PRL and TSH pituitary cells to in vitro TRH treatment.

Hypophysial prolactin (PRL) and thyrotropin (TSH) cells of Rana perezi were examined after treatment in vitro with synthetic thyrotropin-releasing hormone (TRH). Ultrastructural morphometry applied to PRL and TSH immunoidentified cells estimated the volume density (Vv) of the secretory granules (SG), rough endoplasmic reticulum (ER), and Golgi complex (GC) as well as the numerical density (Nv) of the granules. Hemipituitaries were cultured in a superfusion system with or without 100 ng TRH/ml for 4, 14, or 24 hr. PRL cells showed significant degranulation (42%) of medium size SG after 14 hr of stimulation, whereas the biosynthetic machinery (ER and GC) was significantly developed after 4 hr of TRH culture (increase of Vv of GC, 1.5-fold, and ER, 1.3-fold, in comparison to the control). Most of these changes remained after 24 hr of TRH treatment. Compared with controls, TRH-treated TSH cells differed only after 24 hr when SG showed degranulation (40%), mainly of the medium size ones, and Vv of GC (1.6-fold) and ER (1.3-fold) increased. These results suggest that TRH acts directly on amphibian PRL and TSH cells stimulating hormonal synthesis and release. The time courses of responses to TRH differed in that PRL cells gave an immediate response while TSH cells gave a more delayed reaction.


Brain content and plasma concentrations of arginine vasopressin in an Australian marsupial, the brushtail possum Trichosurus vulpecula.

Arginine vasopressin (AVP) has been identified and quantified in the brain and plasma of the possum using a highly specific radioimmunoassay and high-performance liquid chromatography. Large amounts of AVP were found in the pituitary (16.3 +/- 0.56 micrograms/pituitary, n = 5) and hypothalamus (398 +/- 82.5 ng/hypothalamus), and significant amounts of AVP were also present in the cerebral cortex (26.8 +/- 11.5 ng/cortex). Plasma AVP concentrations were significantly lower (2.2 +/- 0.45 pg/ml, n = 10) during anesthesia compared to concentrations while conscious (4.5 +/- 1.19 pg/ml). Severe hemorrhage markedly increased plasma concentrations to 1091 +/- 225 pg/ml (n = 8). It was concluded that AVP is present in the possum brain, pituitary, and plasma, and that its secretion is stimulated by hypovolemia and inhibited by surgical stress.


Formation of ecdysteroids by Y-organs of the crab, Menippe mercenaria. I. Biosynthesis of 7-dehydrocholesterol in vivo.

Y-organs of the xanthid crab, Menippe mercenaria, secrete ecdysteroid hormones in vitro, apparently both 3-dehydroecdysone and 25-deoxyecdysone. Studies were initiated on the biosynthetic path(s), in which cholesterol is converted to these ecdysteroids. Crabs were injected with [3H]cholesterol. Y-organs and hemolymph were removed 12 hr later and extracted directly and the extracts were analyzed by HPLC. Both polar and nonpolar sterols were surveyed. The only metabolite of cholesterol detectable in Y-organs was 7-dehydrocholesterol (identified by mass spectrometry). The total amount of 7-dehydrocholesterol and the amount that was labeled were generally greater than for cholesterol and were higher in Y-organs from de-eyestalked crabs than in those from intact crabs. Subcellular fractionation of the Y-organs showed that over 70% of total radioactivity was in cholesterol and 7-dehydrocholesterol of mitochondria and microsomes, distributed about equally between the two organellar fractions. In hemolymph, the only nonpolar sterols present were cholesterol and 7-dehydrocholesterol; the concentration ratio was 20:1. However, 7-dehydrocholesterol was not significantly labeled. Analyses of polar compounds revealed two prominent, uv-absorbing ecdysteroids which coeluted with the authentic standards, 3-dehydro-20-hydroxyecdysone and 25-deoxy-20-hydroxyecdysone (ponasterone A). The radioactivity profile showed, in addition, a third prominent peak that corresponded in retention time with 3-dehydroecdysone. These results indicate that the Y-organs in vivo form 7-dehydrocholesterol from cholesterol and convert the latter to secretion products without accumulation of other intermediates. At least two ecdysteroids are secreted and appear to be converted peripherally in this crab to their respective 20-hydroxy derivatives.


[Heterogeneity of immunologic subtypes of blast crisis in chronic myeloid leukemia].

Phenotyping of blood cells derived from 12 patients with chronic myeloid leukemia in blast crisis with the use of Mab panel to differentiation antigens of human hemopoietic cells in a flow cytofluorimeter revealed heterogeneity of immunological phenotypes of blast cells. Subclones of blast cells were detected within each subset of disease at several successive stages of differentiation. The qualitative and quantitative composition of cell populations differing in immunological parameters is changed as a result of therapy given.


Formation of ecdysteroids by Y-organs of the crab, Menippe mercenaria. II. Incorporation of cholesterol into 7-dehydrocholesterol and secretion products in vitro.

The conversion in vitro of cholesterol (Ch) to nonpolar metabolites and ecdysteroids was studied in Y-organs of the xanthid crab, Menippe mercenaria. In one set of experiments, Y-organs were prelabeled in vivo by injecting crabs with 100 microCi of [3H]Ch, and halved glands were then incubated for 24 and 48 hr in the presence of unlabeled Ch. In another set, unlabeled Y-organs were incubated in standard medium containing 10 microCi/ml of [3H]Ch. Both polar and nonpolar metabolites were surveyed by HPLC. The early metabolite, 7-dehydrocholesterol (7-dhCh), was the only labeled derivative of Ch detectable in Y-organ tissue after incubation; preincubation amounts of 7-dhCh were higher in glands from de-eyestalked crabs vs glands from intact crabs, and labeling was an order of magnitude higher in glands incubated with labeled Ch vs those prelabeled in vivo. Specific activity calculations indicate highly efficient conversion of 7-dhCh to ecdysteroid secretions. Analyses of the incubation media revealed two polar secretory products, synthesized from Ch in vitro. These coeluted with the authentic standards, 3-dehydroecdysone and 25-deoxyecdysone. Secretion of 3-dehydroecdysone always exceeded that of 25-deoxyecdysone (ratio range, 1.9 to 14.4), in both de-eyestalked and intact crabs.


Regulation of corpus luteum function in the pouched mouse, Saccostomus campestris.

Regulation of corpus luteum function was studied in pouched mice, housed under controlled conditions (14L:10D), (22 +/- 2 degrees C). Prolactin in daily doses of 32 IU promoted luteal and uterine development and markedly increased plasma levels of progesterone in females exhibiting estrous cycles. Negligible levels of progesterone in prolactin-treated ovariectomized females ruled out the possibility of a significant nonovarian source of progesterone. Domperidone (a dopamine antagonist) induced pseudopregnancy in cycling females, with a marked increase of peripheral progesterone levels. Pseudopregnancy was also induced by artificial vaginal stimulation of cycling females according to a multiple intromission-multiple ejaculation pattern or a shorter, more concentrated stimulation pattern. The latter treatment, however, resulted in a much weaker histological response of the corpora lutea and uterine horns, although plasma levels of progesterone were similar in the two treatment groups. Recently mated females given domperidone daily did not have progesterone levels above those of mated females treated with vehicle only (both groups pregnant). Bromocriptine (a dopamine agonist) prevented newly mated females from becoming pregnant and interrupted pregnancy when given from Day 6 onward. The progesterone level in these females was lowered. A GnRH-antagonist given to ovariectomized females significantly suppressed LH levels, but intact females given artificial vaginal stimulation and treated with an GnRH antagonist became pseudopregnant. These findings indicate that, in the pouched mouse, as in many other rodent species, pseudopregnancy and progesterone production are dependent on prolactin and not on LH.


20-Hydroxyecdysone stimulates molting in pycnogonid larvae (Arthropoda, Pantopoda).

Molting in pycnogonid larvae, Pycnogonum litorale, is accelerated by exposing the animals to 20-hydroxyecdysone at concentrations of 10 to 1000 ppm during Days 5 to 9 after the first ecdysis. Hormone application at the beginning or at the end of the molt cycle, as well as treatment all through the molt cycle, delays or even inhibits the molt by upsetting the sequence of molting processes.


Adrenergic modulation of Ca2+ homeostasis in isolated fish hepatocytes.

Isolated hepatocytes of the American eel (Anguilla rostrata LeSueur) and brown bullhead (Ictaluras nebulosus) have been used to characterize the effects of alpha- and beta-adrenergic agonists (epinephrine, phenylephrine, isoproterenol) and antagonists (phentolamine, propranolol) on calcium flux (influx, efflux) and cytosolic free calcium concentrations ([Ca2+]i). Bullhead hepatocytes have higher influx but lower efflux of Ca2+ than eel hepatocytes, which may relate to the primary source for changes in [Ca2+]i. Adrenergic agonists did not affect influx, but significantly enhanced efflux in eel hepatocytes (not bullhead) and [Ca2+]i in both species. Increases in efflux and in [Ca2+]i were blocked by alpha-antagonists (phentolamine) but not beta-antagonists (propranolol) when present in 100-fold excess of the agonist. Isoproterenol had no significant effect on either parameter tested. This study supports our hypothesis that liver cell Ca2+ homeostasis is modulated by alpha-adrenoceptor-linked pathways in these two fish species as has been previously demonstrated for the rat.


Detection of Met-enkephalin in the pars intermedia of the lampreys, Ichthyomyzon castaneus and Petromyzon marinus.

Acid extracts of the brain and pars intermedia of the chestnut lamprey, Ichthyomyzon castaneus, were fractionated by a combination of gel filtration chromatography and reversed-phase HPLC, and screened with RIAs specific for Met-enkephalin and Leu-enkephalin, respectively. In the brain extract, both Met-enkephalin and Leu-enkephalin were detected in a molar ratio of approximately 4:1. These results would suggest that these two enkephalins were derived from a lamprey Proenkephalin precursor. However, reversed-phase HPLC analysis of the pars intermedia of this species revealed the presence of Met-enkephalin, but not Leu-enkephalin. Analysis of the pars intermedia of the marine lamprey, Petromyzon marinus, also indicated the presence of Met-enkephalin but not Leu-enkephalin. These results would suggest that the Met-enkephalin present in the pars intermedia of lampreys may not be derived from Proenkephalin, but may originate from another opioid precursor. This possibility and alternative hypotheses to explain these observations are discussed.


Identification of growth hormone molecular variants in chicken serum.

It has been described that pituitary growth hormone shows molecular and functional heterogeneity. In birds, size and charge variants of chicken growth hormone (cGH) have been shown in the chicken pituitary gland and in purified preparations of the hormone. Here we demonstrate the existence of cGH molecular isoforms in chicken serum, thus suggesting that they are secreted from the gland. The isolation of total cGH present in sera was performed by immunoaffinity chromatography employing a specific monoclonal antibody against cGH. Different analytical electrophoretic methods (SDS-polyacrylamide gel electrophoresis, isoelectric focusing, bidimensional polyacrylamide gel electrophoresis) followed by Western blot and immunostaining were employed to characterize the serum cGH isoforms, and compared to those present in a fresh pituitary extract. Several identical immunoreactive bands comigrated in both serum and the gland extract in the different systems (SDS-PAGE, MW 16, 22, 26, 29, 52, 62, 66 kDa; IEF, pIs 8.1, 7.5, 7.1, 6.8, 6.2), thus revealing a high correspondence of molecular isoforms of the hormone in the two tissues. Additionally, a glycosylated variant of chicken growth hormone (G-cGH) was also revealed in the serum after concanavalin A-Sepharose chromatography.


Uterine metabolic activity and steroid receptor concentrations in response to suppressed secretion of PRL in anestrous mink.

Two experiments were conducted to evaluate the effects of bromocriptine, melatonin (MLT), and 17 beta-estradiol (E2) on uterine physiology in mink (Mustela vison). In Expt. 1, summer-anestrous mink were injected sc daily with 2 mg bromocriptine or vehicle (n = 20 each) for 14 days. On Day 14, both groups were divided into two subgroups and injected sc with either 100 micrograms E2 or vehicle. Mink were bled immediately prior to euthanasia (24 hr after E2) and the sera analyzed for prolactin (PRL), E2 and progesterone (P4). At necropsy, aliquots of uterine tissue (n = 5) were used to measure in vitro oxidation of [14C]glucose, incorporation of [3H]thymidine into DNA and [14C]leucine into protein, and nuclear concentrations of estrogen receptor (ER) and P4 receptor (PR). In Expt. 2, anestrous mink were assigned to one of two treatment groups or a control group (n = 5 each). In mid-summer, groups 1 and 2 were implanted with 10 mg Silastic MLT implants. Seventeen weeks later, mink in group 1 received 100 micrograms E2 (sc) while group 2 and nonimplanted controls (group 3) were injected with vehicle. Mink were sacrificed 24 hr after injection and levels of PRL, E2, P4, ER, and PR determined. Bromocriptine suppressed serum concentrations of PRL (P < 0.001), increased serum levels of E2 (P < 0.05) and levels of PR (P < 0.01), but had no effect on levels of P4, uterine weight, glucose oxidation, DNA and protein synthesis, or concentrations of ER.(ABSTRACT TRUNCATED AT 250 WORDS)


Involvement of the central nervous system in neuroendocrine mediation of osmotic and ionic regulation in the freshwater shrimp Macrobrachium olfersii (Crustacea, Decapoda).

The presence of putative neurofactors within the central nervous system, i.e., the eyestalks (ES), ventral nerve cord (VNC), and supra-esophageal (SEG) and thoracic ganglia (TG), which are involved in osmotic and ionic regulation, was investigated in the euryhaline, freshwater shrimp, Macrobrachium olfersii. Homogenates were prepared from shrimps exposed for 6 hr to a high salinity medium (HSM, 21/1000 S) and were injected into shrimps subsequently maintained for 1, 3, or 6 hr in freshwater (FW, 0/1000 S) or HSM. Osmolality and sodium, chloride, and calcium concentrations were determined in single hemolymph samples removed at each time interval. Heart rates and wet weights were measured before and after experimental treatments. Exposure to HSM increased [Na+] and [Cl-] and heart rate. Injection of ES homogenate increased osmolality, [Na+] and [Cl-], and wet weight in shrimps maintained in FW; VNC homogenate also increased hemolymph [Cl-] in shrimps maintained in FW after injection, but reduced heart rate in shrimps subsequently exposed to HSM. Injection of TG homogenate reduced heart rate to a lesser extent in shrimps maintained in FW. Hemolymph [Ca2+] was not altered by homogenate injection. The exposure period of 6 hr to HSM appears to result in the accumulation of factors within the central nervous system that regulate the osmotic and ionic concentrations of the hemolymph, in addition to exerting antidiuretic and cardio-depressor actions. The coordinated action of these factors is intimately involved in the hyporegulatory processes that permit the survival of M. olfersii in media of elevated salinity.


Effects of light on melatonin and two enzymes leading to its production in albino (s(al-c)) and nonalbino chickens.

A gene for sex-linked imperfect albinism in the chicken (s(al)) has been associated with increased egg production with an implication that environmental light may play a role. In this study, levels of melatonin and hydroxyindole O-methyltransferase (HIOMT) and N-acetyltransferase (NAT), two enzymes leading to melatonin production, were studied in young albino and nonalbino chickens in relation to the daily light cycle, and after 19 days of constant light or dark. Differences between genotypes were found in the levels of HIOMT activity in the pineals and retinas of birds kept in constant light for 19 days. Other measurements were not significantly different. This study would appear to show that the visual system of imperfect albino chickens reacts differently to light than that of nonalbinos, but not with changes in the daily cycle of plasma melatonin or in NAT activity, which is the enzyme primarily responsible for the control of the melatonin level in the body.


The new approaches to whole genome analysis of bacteria.

A range of recombinant DNA techniques now enables whole genome analysis of any bacterium to be carried out without recourse to the classical means of bacterial genetic exchange. Using enzymes which cut infrequently, such as SpeI, combined with pulsed field gel electrophoresis, a physical map of ordered fragments can be constructed. By means of cloned fragments of known genes or oligonucleotides synthesized using data from DNA or protein sequence banks, the location of individual genes on this map can be determined. We have used these techniques to study whole genome structure in three species of Pseudomonas: P. aeruginosa, P. putida and P. solanacearum.


Genome diversity at the serA-linked capsule locus in Escherichia coli.

Individual isolates of Escherichia coli synthesize one of more than 70 chemically distinct polysaccharides which form the capsule. In this article we review the genetics of capsule production in E. coli and highlight what this is beginning to reveal in terms of the genetic basis of the structural diversity of polysaccharides. The serA-linked capsule locus can take three different allelic forms. Two of these are associated with capsule genes and are themselves internally variant, whilst the third form has not so far been implicated in capsule biogenesis. Thus the serA-linked region of the E. coli genome is strikingly polymorphic.


An analysis of the codon usage of Pasteurella haemolytica A1.

Analysis of approximately 17 kbp of nucleotide sequences from three different regions of the genome of Pasteurella haemolytica A1 showed that the mol% G+C of P. haemolytica A1 DNA is 38.5%. When only the coding sequences (approx. 10 kbp) were analysed, a similar value of 38.8% was obtained. A comparison of the relative synonymous codon usage values of the cloned genes showed that P. haemolytica A1 has a very different codon usage pattern from that of Escherichia coli.


Small molecule-mediated density-dependent control of gene expression in prokaryotes: bioluminescence and the biosynthesis of carbapenem antibiotics.

Sophisticated signal transduction systems enable prokaryotes to sense their growth environment and mount an appropriate adaptive response. Signal transduction and gene regulation through the phosphorylation of two regulatory components is now recognised as one of the major global regulatory networks in bacteria. However, not all types of sensor-regulator circuits relay information via phosphoryl transfer. The Vibrio fischeri LuxR protein which has previously been characterised as a member of the response-regulator superfamily responds to a small diffusible signal molecule N-(3-oxohexanoyl)homoserine lactone (HSL). Biosynthesis of HSL in V. fischeri is dependent on the expression of the luxI gene. Until recently, the role of HSL as an 'autoinducer' was thought to be restricted to V. fischeri and a few related marine bacteria in which it controls the onset of bioluminescence. However, we have discovered that a diverse group of terrestrial bacteria: (1) produce HSL; (2) possess genes analogous to luxI; and (3) exhibit cell density-dependent induction of bioluminesence when transformed with a recombinant plasmid carrying V. fischeri lux genes but lacking luxI. In one of these, Erwinia carotovora, HSL is shown to mediate the cell density-dependent biosynthesis of a carbapenem antibiotic.


Physiological and energetic aspects of bacterial metabolite overproduction.

This review attempts to provide a rational explanation for microbial metabolite over-production, a phenomenon manifest with many wild-type and mutant organisms. After analysing the relationships between catabolic and anabolic processes within the growing cell (which point to the presence of sufficient kinetic control elements to ensure a stringent coupling between the two), consideration is given to mechanisms that might allow the rate of catabolism to be varied independently of the rate of anabolism. It is in this latter context that an excretion of specific metabolites appears to play a key role.


Expression of periplasmic binding proteins for peptide transport is subject to negative regulation by phosphate limitation in Escherichia coli.

It is well recognised that phosphate limitation in Escherichia coli causes enhanced synthesis of a variety of proteins involved in maximising the uptake and utilisation of the available phosphate. In contrast to this situation, we report here that these same conditions repress synthesis of the periplasmic binding proteins for both the oligopeptide (Opp) and dipeptide permeases (Dpp), and of certain other periplasmic proteins. Regulation in the former case is mediated by the Pho regulon; genes controlled by this mechanism lack efficient -35 promoter regions, and instead, an activator protein, PhoB, binds to a specific 'Pho box' sequence, ten bases upstream from a -10 promoter, thereby facilitating binding of RNA polymerase and leading to enhanced transcription. In the latter case, putative Pho boxes can be identified in the promoter regions of opp and dpp (and of other binding proteins), but in these genes they overlap the RNA polymerase binding sites of good promoters. We speculate that this different Pho box location may allow PhoB to act as a repressor of transcription of these genes. The promoter region for the sigma factor, sigma 32, (RpoH) also contains a putative Pho box, implying that it may be involved in the enhanced synthesis and secretion of proteins required under phosphate limitation.


TonB-independent ferrioxamine B-mediated iron transport in Escherichia coli K12.

The TonB protein of Escherichia coli K12 couples the energized state of the cytoplasmic membrane with energy-dependent receptors in the outer membrane. High affinity iron transport mediated by ferric dicitrate, ferrienterobactin, ferriaerobactin, ferrichrome, and coprogen all require a functional tonB protein. However, we have found no difference between the growth rates of tonB+ strains and tonB strains using ferrioxamine B as the sole iron source. This TonB-independence of FOB transport and earlier results with a photoactive FOB analog indicate a separate mechanism for iron acquisition from FOB in E. coli.


Low temperature induced non-culturability and killing of Vibrio vulnificus.

Vibrio vulnificus cells progressively lose culturability during incubation at 5 degrees C. This process is accelerated by the addition of supernatants from non-culturable cells obtained by incubation at 5 degrees C for 17 days. Thus the organism apparently produces a factor upon cold incubation which is triggering or causing the decline in culturability. Reversing the temperature shift can restore a culturable population comparable in numbers to the original population, but this process is largely due to regrowth. A few cells retaining the ability to grow apparently utilize the substrates released by the moribund cells, thus mimicking resuscitation of the whole population.


The effect of iron limitation on expression of the aerobic and anaerobic electron transport pathway genes in Escherichia coli.

To determine whether the aerobic and anaerobic respiratory pathways of Escherichia coli are regulated in response to iron availability, strains containing lacZ reporter fusions to the cydAB, cyoABCDE, narGHJI, dmsABC and frdABCD operons were grown in medium limited for iron by use of the chelator, 2,2'-dipyridyl. Under anaerobic conditions, expression of the anaerobic respiratory pathway operons, narG-lacZ, dmsA-lacZ and frdA-lacZ, was reduced 14-16 fold when iron was limited. In contrast, expression of the aerobic pathway operons, cyoA-lacZ and cydA-lacZ, was elevated modestly. Iron-dependent transcriptional control of these operons was independent of the fur gene which encodes an iron-and-DNA-binding regulatory protein. The expression of fnr-lacZ was relatively unaffected by iron limitation suggesting that Fnr levels in the cell do not change in response to iron. The above findings suggest that in addition to Fur, some other cellular protein may bind iron for reporting and regulating iron-dependent cell functions.


Incompatibility of outer membrane proteins OmpA and OmpF of Escherichia coli with secretion in Bacillus subtilis: fusions with secretable peptides.

The secretion of the outer membrane proteins OmpA and OmpF of Escherichia coli has previously been found to be blocked at an early intracellular step, when these proteins were fused to a bacillar signal sequence and expressed in Bacillus subtilis. We have now fused these proteins to long secretable polypeptides, the amino-terminal portions of alpha-amylase or beta-lactamase. In spite of this, no secretion of the fusion proteins was detected in B. subtilis. With the exception of a small fraction of the beta-lactamase fusion, the proteins were cell-bound with uncleaved signal sequences. Protease accessibility indicated that the fusion proteins were not even partially exposed on the outer surface of the cytoplasmic membrane. Thus there was no change of the location compared to the OmpA or OmpF fused to the signal sequence only. We conclude that, like OmpA and OmpF, the fusion proteins fold into an export-incompatible conformation in B. subtilis before the start of translocation, which we postulate to be a late post-translational event.


Construction and properties of pyruvate dehydrogenase complexes with up to nine lipoyl domains per lipoate acetyltransferase chain.

The lipoate acetyltransferase (E2p) subunits of the pyruvate dehydrogenase (PDH) complex of Escherichia coli have three tandemly repeated lipoyl domains, although net deletions of one or two has no apparent effect on the activity of the purified complexes. Plasmids containing IPTG-inducible aceEF-lpd operons, which encode PDH complexes bearing from one to nine lipoyl domains per E2p chain (24-216 per complex), were constructed. They were all capable of restoring the nutritional lesion of a strain lacking PDH complex and they all expressed active sedimentable multienzyme complexes having a relatively normal range of subunit stoichiometries. The extra domains are presumed to protrude from the E2p core (24-mer) without significantly affecting the assembly of the E1p and E3 subunits on the respective edges and faces of the cubic core. However, the catalytic activities of the overproduced complexes containing four to nine lipoyl domains per E2p chain were lower than those with fewer lipoyl domains. This could be due to under-lipoylation of the domains participating in catalysis and interference from unlipoylated domains.


Lipase of Staphylococcus hyicus: analysis of the catalytic triad by site-directed mutagenesis.

In this study the putative catalytic triad Ser-His-Asp of the Staphylococcus hyicus ssp. hyicus lipase was investigated. Putative catalytic sites determined by homology comparisons of three staphylococcal and other non-staphylococcal lipases were altered by site-directed mutagenesis. Since the mutations did not influence the secretion of the lipase, the decrease in lipase activity of the mutants strongly supports the proposed involvement of Ser369 and His600 in catalysis. Asp559 is postulated to be the third amino acid of the triad.


Specific removal of chlorine from the ortho-position of halogenated benzoic acids by reductive dechlorination in anaerobic enrichment cultures.

Anaerobic enrichment cultures catalysing the reductive dechlorination of chlorinated benzoic acids were obtained from three fresh-water sediments collected from seven different locations. Sub-cultures from these enrichments specifically removed ortho-substituted chlorine from 2,3,6-, 2,3,5- and 2,4,6-trichlorobenzoic acid, yielding chloride and 2,5-, 3,5-, and 2,4-dichlorobenzoic acids, respectively. These reductive dehalogenations were stimulated by the addition of benzoate and/or volatile organic acids. In one of these enrichments dehalogenation of ortho- and/or para-chlorine substituents was also observed from 2,3-, 2,4-, 2,5-, and 3,4-dichlorobenzoic acid, yielding 3- and 4-chlorobenzoate. Removal of meta-chlorines was not observed in any of the enrichments.


Growth temperature-dependent activity of glycerol dehydratase in Escherichia coli expressing the Citrobacter freundii dha regulon.

Using the cosmid pWE15, a genomic library of Citrobacter freundii DNA in Escherichia coli ECL707 was prepared and screened for glycerol utilization. Six out of approximately 3000 clones were positive. One clone, harboring the recombinant cosmid pRD1, expressed glycerol dehydratase in high activity when grown at 28 degrees C but not at 37 degrees C. The growth temperature had little effect on the activity of the other enzymes encoded by the dha regulon. When the glycerol-containing medium was supplemented with corrinoids, the recombinant E. coli strain produced 1,3-propanediol in high amounts at 28 degrees C.


The sialylation of gonococcal lipopolysaccharide by host factors: a major impact on pathogenicity.

The resistance of gonococci in most patients to complement mediated killing by human serum is due to sialylation of their lipopolysaccharide (LPS) which prevents bactericidal antibody from reacting with target sites. Two of the host factors responsible are: cytidine 5'-monophospho-N-acetyl neuraminic acid (CMP-NANA), a well-known sialylating agent, and another factor which enhances the transfer of sialyl groups from CMP-NANA to LPS catalysed by a gonococcal sialyltransferase. The bacterial determinant of resistance is a conserved LPS component of about 4.5 kDa which is sialylated at a terminal Gal beta 1-4GlcNAc site on its side chain. The sialylated LPS forms a surface coat which is stainable by ruthenium red and connected with previously described 'capsules'. These observations sparked off an explosion of research. Recent publications show that sialylation of LPS by CMP-NANA affects additional important aspects of gonococcal pathogenicity, notably interactions with antibodies and phagocytes, and rendering the gonococcal surface more 'host-like'. Also, the observations have prompted an examination of LPS from some other pathogens for the presence of sialyl groups with positive results for Neisseria meningitidis and Haemophilus influenzae.


Serratia marcescens forms a new type of cytolysin.

Most Serratia marcescens strains produce a new type of cytolysin (hemolysin) which is also found in other Serratia species. The hemolytic polypeptide ShlA (M(r) 162 101) is secreted across the outer membrane through the help of the ShlB protein which also involves conversion of an inactive precursor in an hemolytically active form. Both proteins are synthesized with signal sequences which are released during export across the cytoplasmic membrane. Mutants expressing inactive ShlB derivatives are impaired in activation and secretion suggesting a tight coupling between both processes. The region of ShlA for activation and secretion is confined to the N-terminal 16% of the polypeptide which contains the sequence NPNG which is also found in the Proteus hemolysin, the Bordetella pertussis filamentous hemagglutinin and two highly expressed outer membrane proteins of Haemophilus influenzae. Substitution of the first asparagine (N) residue by isoleucine converts the Serratia hemolysin into an inactive secretion incompetent form. It is concluded that this region is recognized by ShlB for activation and secretion of ShlA. The Serratia hemolysin forms defined pores in erythrocyte membranes.


Erythrogenic toxins A, B and C: occurrence of the genes and exotoxin formation from clinical Streptococcus pyogenes strains associated with streptococcal toxic shock-like syndrome.

We report the study of 53 clinical isolates of group A streptococci, all from patients with streptococcal toxic shock-like syndrome. The strains were analysed for the occurrence of the genes of erythrogenic toxins (pyrogenic exotoxins) types A, B and C and in vitro production of these toxins. In contrast to reports indicating that 85% of the toxic shock-like syndrome-associated isolates contained the erythrogenic toxin A gene, only 58.5% of our strains harboured this gene. The erythrogenic toxin C gene was detected in 22.6% of the isolates. Erythrogenic toxin A and erythrogenic toxin B were produced by 68.7% and 58.3% of the strains containing either gene. For all group A streptococci, irrespective of clinical association, the erythrogenic toxin B gene was detected in all the isolates tested. Thus, it is difficult to define a specific role for erythrogenic toxin B in toxic shock-like syndrome as there was no clear correlation between this disease and the presence of toxin genes. Our results suggest the existence of other pathogenic factor(s) produced by group A streptococci which may stimulate human peripheral T lymphocytes in a manner similar to that of erythrogenic toxins, thus explaining different observations in previous epidemiological genetic studies.


Mucoid Pseudomonas aeruginosa and cystic fibrosis: the role of mutations in muc loci.

Mucoid alginate-producing mutants of Pseudomonas aeruginosa are major pathogens in debilitating chronic pulmonary infections in patients with cystic fibrosis. The mucoid phenotype results from alginate biosynthesis whose genes are arranged in at least three chromosomal loci. Structural genes are located at the 34-min region and regulatory genes at 9 min. A third cluster at the 70 min region contains muc mutations which affect transcription of a key structural gene, algD, in response to environmental stimuli. Control of mucoidy includes bacterial signal transduction systems, histone-like elements controlling nucleoid structure and, possibly, factors affecting superhelicity. Thus, the control of mucoidy in P. aeruginosa has become one of the focal systems for analysis of how bacterial pathogens adapt to the host environment.


Cytotoxic fungal spores in the indoor atmosphere of the damp domestic environment.

Eight-three fungal isolates collected and cultured from the air spora of damp public sector Scottish housing have been screened for cytotoxic properties. A bioassay procedure has been utilised for this purpose involving cytotoxic effects on human embryonic diploid fibroblast lung cells grown as monolayer cultures within the wells of microtitre plates. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] biochemical assay system employed has revealed that 39 (47%) of the moulds investigated possessed spore-associated cytotoxic properties; a value which emphasises the potential health hazards of the continual inhalation of toxigenic fungal propagules by occupants of mouldy houses. Penicillia, the most prevalent fungi found in the internal atmosphere of the domestic environment, accounted for the great majority of cytotoxic strains identified.


Transformation-mediated exchange of virulence determinants by co-cultivation of pathogenic Neisseriae.

The horizontal flow of genetic material between microbes utilizes three principal routes: conjugation, transduction and transformation. While the significance in nature of the first two pathways is generally accepted, the in vivo role of transformation remains uncertain, despite the early observations by Griffith in 1928 on the transformation of streptococci from an avirulent to a virulent state [1]. Recently, circumstantial evidence was collected suggesting a role for transformation-mediated horizontal exchange in the modulation of virulence determinants of pathogenic Neisseriae and the variation of surface structures. In order to further assess the significance of transformation-mediated exchange we performed simple co-cultivation experiments of different Neisseria strains. We observed an efficient intra- and interspecies transfer of essential virulence determinants; the process was sensitive to the presence of DNaseI in the culture and was blocked in transformation-deficient recipients.


Growth and morphogenesis in Streptomyces.

In this report we propose a model of apical growth for streptomycetes. The apical tip is considered as a multilayered wall that expands by an inside-to-outside mechanism of growth. It is also assumed that each layer is made up of peptidoglycan blocks, each of them being the result of the biosynthetic activity of a wall-synthesizing unit or membrane-associated growth zone. According to our model, apical growth occurs as follows: as a consequence of the hydrostatic pressure and the cleavage of some bonds, the layers are pushed and forced to slide (one with respect to the other), migrating from the center of the tip (at the inside of the wall) towards a peripheral location (at the outside of the wall). The model also incorporates a mechanism by which apical growth can be regulated and coordinated with the replication of the chromosome.


Chromatins of low-protein content: special features of their compaction and condensation.

Histonic chromatin with a relatively high-protein content (RPC of about 1) is compared with naturally occurring chromatins of low-protein contents (RPCs of less than 0.5). The features of these chromatins, with respect to compaction and condensation, are discussed. Liquid crystalline chromatin, as found in dinoflagellates and phage heads, can apparently only be formed by condensation of chromatin of low-protein content and when it is not supercoiled. With histonic chromatin, liquid crystals are never found. Chromatins with low-protein contents might also form compactosomes (or 'labile nucleosomes'), as, for instance, in bacteria. They are forms of supercoiled DNA without a protein core and are so labile that they are difficult to study and even to detect. Chemical fixatives, as commonly used for electron microscopy, do not cross-link the chromatins of low-protein content, a feature which they share with naked DNA. It is postulated that these fixatives even relax the existing supercoil, which seems to be preserved after cryofixation only.


Some controls on oligosaccharide utilization by yeasts: the physiological basis of the Kluyver effect.

Many yeasts can aerobically catabolize exogenously supplied glycosides that are hydrolysed in the cytosol, but few do so anaerobically. This is so, even for yeasts that use one or more of the component hexoses anaerobically. The phenomenon, called the Kluyver effect, appears to be brought about by a combination of the following four factors: (i) fast transport of the glycosides into the cells involves proton symport and seems to require aerobiosis, so, under anaerobic conditions, the glycosides enter the cells much more slowly. This is probably because there is less ATP produced anaerobically than aerobically and, consequently, insufficient to supply the proton pump optimally, which is necessary to maintain proton symport; (ii) in addition, anaerobically, the transport carrier may have a lower substrate affinity; (iii) glycosidases generally have low substrate affinities; and (iv) the consequence of (i), (ii) and (iii) is a lowering of glycolytic flux and this deactivates pyruvate decarboxylase.


Hansenula polymorpha: an attractive model organism for molecular studies of peroxisome biogenesis and function.

In wild-type Hansenula polymorpha the proliferation of peroxisomes in induced by various unconventional carbon- and nitrogen sources. Highest induction levels, up to 80% of the cytoplasmic volume, are observed in cells grown in methanol-limited chemostat cultures. Based on our accumulated experience, we are now able to precisely adjust both the level of the peroxisome induction as well as their protein composition by specific adaptations in growth conditions. During the last few years a series of "peroxisome-deficient (per) mutants of H. polymorpha have been isolated and characterized. Phenotypically these mutants are characterized by the fact that they are not able to grow on methanol. Three mutant phenotypes were defined on the basis of morphological criteria, namely: (a) mutants completely lacking peroxisomes (Per-;13 complementation groups); (b) mutants containing few small peroxisomes which are partly impaired in the peroxisomal import of matrix proteins (Pim-; five complementation groups); and (c) mutants with aberrations in the peroxisomal substructure (Pss-; two complementation groups). In addition, several conditional Per-, Pim- and Pss- mutants have been obtained. In all cases the mutant phenotype was shown to be caused by a recessive mutation in one gene. However, we observed that different mutations in one gene may cause different morphological mutant phenotypes. A detailed genetic analysis revealed that several PER genes, essential for peroxisome biogenesis, are tightly linked and organized in a hierarchical fashion. The use of both constitual and conditional per mutants in current and future studies of the molecular mechanisms controlling peroxisome biogenesis and function is discussed.


On the post-translational modifications at the C-terminal domain of the major cysteine proteinase (cruzipain) from Trypanosoma cruzi.

Cruzipain, the major cysteine proteinase from Trypanosoma cruzi, has a 130 amino acid-long C-terminal domain, which, although microheterogeneous in SDS-PAGE, has a single N-terminal amino acid sequence. Most of the Thr residues present at the beginning of this sequence are modified; the nature of this modification is still unknown, but O-glycosylation and phosphorylation seem both to be absent. The only potential site for N-glycosylation (Asn 254) is glycosylated in vivo. Most of the eight Cys residues are involved in disulfide bridges. The results are consistent with cruzipain being made of two well-defined domains, a catalytic one with high homology to cathepsin L, and a C-terminal domain, linked to the former by a 'hinge' corresponding to the Pro- and Thr-rich region at its N-terminus.


Peculiar properties of mycoplasmas: the smallest self-replicating prokaryotes.

Mycoplasmas are the smallest and simplest prokaryotes capable of self-replication, with information provided by a genome which may be as small as 600 kb, estimated to carry less than 500 genes. Keeping the number of structural elements, metabolic pathways and components of the protein synthesizing machinery to an essential minimum places mycoplasmas closest to the concept of 'minimum cells'. Mycoplasmas are, therefore, most adequate candidates for the complete deciphering of the machinery of a self-replicating organism, and studies towards this goal are already underway. Living as 'minimum cells' was made possible by adopting a parasitic mode of life, securing from the host the many nutrients which cannot be synthesized by the mycoplasmas themselves. When pathogenic, infections by mycoplasmas usually follow a chronic course, with host immune reactions playing an important role in symptom production. Recent studies on the possible association of mycoplasmas with rheumatoid arthritis and AIDS are reviewed.


Diversity of Pseudomonas plasmids: to what extent?

Results obtained in studies of the biology of Pseudomonas plasmids are presented here as a mini-review. These data indicate that plasmids are ubiquitous in Pseudomonas, but the frequency of their occurrence varies greatly in particular species, or groups of species and in different microbial habitats. Some species of Pseudomonas, for instance P. aeruginosa, possess great diversity of plasmids both from the viewpoint of their incompatibility properties and their ability to endow bacteria with additional features such as resistance to antibiotics or heavy metals, degradation of xenobiotics or inhibition of phage development.


Adjuvanted oral vaccines should not induce allergic responses to dietary antigens.

Oral vaccines may contain adjuvants which might elicit allergies against dietary proteins. Four antigens were used to measure such an effect--ovalbumin, soya bean protein, lactalbumin and gluten. Neither guinea pigs nor mice showed IgE responses after oral administration of adjuvanted vaccines containing lactalbumin and gluten. No IgE responses were detected in mice with any of these antigens after oral immunization, but, in the guinea pig, nine out of 18 animals reacted to either ovalbumin or soya bean protein and none reacted to lactalbumin and gluten. It is concluded that the risk of allergy induction against normal dietary proteins is low but such tests should be applied to potential adjuvanted oral vaccines to measure any possible contraindication, especially with atopic individuals.


Cellulose degradation by Clostridium thermocellum: from manure to molecular biology.

Clostridium thermocellum, a Gram-positive, thermophilic anaerobe produces a highly active cellulase system. This system, termed the cellulosome, is a complex composed of at least 14-18 different types of components organized around a large, cellulose-binding protein. Combining recombinant DNA technology and protein biochemistry has proved to be a successful approach in unravelling some important features of the system.


Rumen microbiology, biotechnology and ruminant nutrition: the application of research findings to a complex microbial ecosystem.

Research on rumen microorganisms has contributed greatly to our understanding of anaerobic microbial ecosystems, and has also influenced feeding practices and nutritional modelling with ruminants. However, it can be argued that rumen microbiology has not yet fulfilled its true potential. Growth-promoting ionophores, antibiotics and microbial feed additives were introduced before their microbiological effects had been determined. A more pro-active role for the microbiologist was predicted with the advent of recombinant DNA technology. Whether ventures in molecular biology can be applied successfully to benefit nutrition and health is likely to depend on whether means can be found for maintaining new strains in vivo.


Enzyme-linked immunosorbent assay for the detection of antibodies to exocellular proteins of Staphylococcus aureus in bone infection.

An enzyme-linked immunosorbent assay (ELISA) was developed for measurement of the antibody response to exocellular protein antigens of Staphylococcus aureus. The wells of a microtitre plate were coated with the exocellular proteins present in the tryptic soya broth growth medium from a stationary phase culture of a bone infection strain of S. aureus. The wells were then reacted sequentially with patient sera, protein A-peroxidase conjugate and chromogenic substrate. Serum from patients with S. aureus bone infection gave a significantly higher IgG titre than sera from patients with Staphylococcus epidermidis or Streptococcus sanguis bone infection or healthy uninfected individuals. The assay therefore appears to have potential in the serodiagnosis of S. aureus bone infection.


Investigation of microbial growth in vivo: evaluation of a novel in vivo chamber implant system.

An intraperitoneal chamber implant system has been used to investigate the phenotype of Staphylococcus aureus growing in the rat and the effect of the antibiotic flucloxacillin on bacterial growth in vivo. Titanium chambers were implanted in the peritoneum: a period of 3-4 days equilibration allowed diffusion of host proteins into the chamber fluid prior to inoculation with bacteria. S. aureus inoculated into the chamber fluid, grew rapidly over a 72 h period, reaching counts of > 10(9) per ml. Organisms harvested from chambers were analysed by SDS-PAGE and showed significant differences in polypeptide profiles from the same strain grown in nutrient broth in vitro. Analysis of whole cell extracts by Western-blotting revealed that protein A expression was repressed in S. aureus grown in vivo. Following subcutaneous administration, flucloxacillin levels in serum peaked earlier and were higher than those detected in chamber fluid. The inhibitory effect of the antibiotic on the growth of S. aureus in chambers in treated animals could be monitored easily by sequential sampling of the chamber fluid. These results indicate the potential of the chamber implant model for investigation of microbial phenotype in vivo and development of alternative methods for assessment of antimicrobial efficacy in vivo.


Experimental conditions may affect reproducibility of the beta-galactosidase assay.

Several experimental conditions and parameters contributing to the determination of beta-galactosidase activity, as proposed in Miller's assay, were studied. Use of the absorbance correction factor and the nature and concentration of permeabilizing agents were taken into account as different experimental conditions. Reaction time, culture volume, and growth stage were investigated as equation parameters. From a quantitative point of view the results, in terms of Miller units, are markedly affected by variation in these conditions. Therefore, to ensure reproducibility it is advisable to use constant values for all the parameters.


[Montaigne and Paracelsus].

After some general remarks on Michel de Montaigne (1533-1592), who died just 400 years ago, the author compares him with another most original thinker of the 16th century: Paracelsus. Montaigne and Paracelsus were akin in their fundamental scepticism about human knowledge and convictions. Speaking, in his "Essais", of medicine Montaigne repeatedly quotes Paracelsus. These quotations show that Montaigne had some knowledge of Paracelsus' writings and that, to some extent, he was in sympathy with his ideas.


["Death of beautiful youth" or youthful suicide in Geneva in the 18th century].

Whether it is the unhappy ending of family grief, the only solution to an unrequited love or due to some pathological behaviour, juvenile suicide horrifies the community of the Ancien Régime, which tends to interpret it as an "illness of the soul" characteristic of a youth that combines bodily vitality with moral frailty, but whose role would be nonetheless to ensure the morrows of mankind. Juvenile suicide underlines the flaws of social solidarity in the tightly knit community of the Ancien Régime, and it deepens the social resentment against willful death which, since 1774, has often been attributed to the harmful influence of the kind of "philosophy" or free will advocated by Goethe's unfortunate Werther.


Meeting the dark: autobiography in Hawthorne's unfinished tales.

This essay discusses the autobiographical implications of Nathaniel Hawthorne's last, unfinished tales. Biographical documents, as well as the tales, demonstrate that Hawthorne's personal condition shaped the characters and ideas in his fiction, particularly the aged protagonist, the meditations on old age and death, and the quest for immortality. The conflict between the moral vision in the tales and his personal attitude toward old age and death caused creative difficulties that he could not overcome.


"To everything there is a season": some Shakespearean models of normal and anomalous aging.

Shakespeare perceived aging characters as falling broadly into two categories: normal and anomalous. The former age in conformity to societal expectations, often displaying an inability to affect the outcome of events; the latter (e.g., Lear and Falstaff), deviating from these behavioral norms, dominate the action of their respective plays. Falstaff, a prime example of the anomalous ager, suffers rejection by King Henry V, his former boon companion, a consequence of ageism.


The effect of aging on dramatic realization of old age: the example of Ingmar Bergman.

Ingmar Bergman's films Wild Strawberries and Fanny and Alexander can be viewed as two readings of the psychosocial world of old age. The picture of aging emerging from Wild Strawberries is dominated by pressure toward resolution, and Fanny and Alexander is governed by fragmentation. Closure and fragmentation are related to the artist's position in the life span at the time of creation. Whereas closure appears to be a midlife attempt to handle death anxiety and a sense of finality, fragmentation is the older Bergman's means of adapting to the experience of aging.


Black grandparents rearing children of drug-addicted parents: stressors, outcomes, and social service needs.

This article reports findings from two qualitative studies of black grandparents and great-grandparents who are rearing their children's children as a consequence of parental drug addiction. Data were collected in two urban black communities from 60 grandmothers, grandfathers, and great-grandmothers (ages 43-82). Only 3% of the respondents received consistent, reliable familial support in their role as surrogate parents. Although respondents found parenting their grandchildren an emotionally rewarding experience, they also incurred psychological, physical, and economic costs in performing their roles.


The physical and emotional health of grandmothers raising grandchildren in the crack cocaine epidemic.

This article explores the physical and emotional health status of 71 African-American grandmothers raising their grandchildren as a result of the crack cocaine involvement of the children's parents. A comparison of self-assessed health ratings with qualitative responses revealed a tendency for respondents to downplay their own health problems and symptoms.


Deaths caused by physical restraints.

A retrospective analysis of 122 deaths caused by vest and strap restraints found that most victims were women (78%) and a median age of 81. Victims were found suspended from chairs (42%) or beds (58%); 83% were in nursing homes. Detailed analysis of 19 cases showed that all were demented, 13 had impulsive or involuntary movements, and 14 had recently tried to escape from a restraint or been found in a dangerous position while restrained. Restraints are an underrecognized, underreported, avoidable, and proximate cause of at least 1 of every 1,000 nursing home deaths.


Risk factors that predict staff failure to release nursing home residents from restraints.

This study identifies resident characteristics related to nursing staff failure to provide consistent release from physical restraints as required by regulation. The lengths of intervals during which residents were restrained were measured and correlated with the staff's perception of degree of care burden and resident behavioural characteristics in order to identify risk factors related to the absence of consistent release. Staff perceptions of residents' verbal aggressiveness (multiple R = -.30, p < .01), physical aggressiveness (multiple R = -.25, p < .03) and unpleasantness (multiple R = -.25, p < .03) are the three characteristics most predictive of the length of time residents continuously remain restrained.


Qualitative analysis of the Program of All-inclusive Care for the Elderly (PACE).

The innovative model of capitated acute and chronic care for nursing-home-eligible elderly persons, which was developed at On Lok in San Francisco's Chinatown and stresses using community care in lieu of institutional care, has been replicated at eight sites around the country. The early experience in developing these sites tests the extent to which the principles of this approach, based on day health care, can be reproduced in a variety of other settings. Four of the eight sites have begun formal capitated care; enrollment has been less active than anticipated, apparently due to reluctance to change physicians and resistance to day care.


Hospital-based case management: results from a demonstration.

The Flinn Foundation Hospital-based Coordinated Care case management demonstration was designed to help patients discharged from six participating hospitals be linked to community services by a case manager. One unexpected result was that about half of the clients served were referred from the community, not from the hospital. We examine the characteristics of hospital-based case management clients, the predictors of their continuation in case management, and their health status over 1 year, focusing on the differences between hospital- and community-referred clients.


Symptoms of depression among older African-Americans: an analysis of gender differences.

Using data from a community-based sample of African-Americans, this study investigated the association between gender and depressive symptoms among 148 African-Americans who are 65 years of age and older. Findings indicated no gender difference in overall level of depressive symptomatology. Further analyses suggest that the lack of a gender difference in depressive symptoms was attributable to similarities in risk factors related to stressful life events and the social roles associated with employment and childrearing.


Living arrangements of the elderly: an examination of differences according to ancestry and generation.

Using data from the November 1979 Current Population Survey, the pattern of living with relatives among American elderly of European origin was examined. The data show that, in general, the elderly with Southern, Central, and Eastern European ancestries were more likely to live with relatives than were their Northwestern European counterparts. There were exceptions, most notably those elderly with a Russian background. There was no decreased likelihood of living with relatives among those with more generations in the United States.


The relationship between program participation, use of formal in-home care, and satisfaction with care in an elderly population.

This study used data from the Channeling Demonstration to investigate the relationship between program participation, utilization of formal in-home services, and client satisfaction in an elderly population. Age, being male, severe ADL dependency, living alone with no informal support, provision of basic case management services, and utilization of formal in-home services were significant predictors of satisfaction.


Clinical assessment of family caregivers in dementia.

Development of an integrated family assessment inventory based on the Double ABCX and Circumplex models of family functioning and its clinical utility was evaluated with 121 primary family caregivers from a cognitive disorders program. The proposed model predicted a significant proportion of the variance associated with caregiver stress and strain. Several aspects of the caregiving arrangement also emerged as key features in predicting caregiver depression. These findings supported the model's central premise that both dyadic (caregiver-patient) and systemic (caregiver-family) variables are salient in assessing the impact of family caregiving with dementia.


Psychotropic drug use in long-term care facilities: a review of the literature.

We reviewed 19 studies of psychotropic drug use for residents of long-term care facilities, located through a MEDLINE search of the literature published between 1978 and 1990. The review compares each study in terms of its sample, research design, and findings. The studies reviewed found that a substantial proportion of nursing home residents are taking psychotropic drugs on a regular, long-term basis and this usage is accompanied by prescribing and monitoring problems and many potential adverse risks.


The impact of an interinstitutional relocation on nursing home residents requiring a high level of care.

Residents of two older nursing homes (n = 196) were relocated to a new 238-bed facility. A nonequivalent control group (n = 74) design with two pretests and two posttests was used to assess the impact of this move on their well-being and health. The relocated residents and control-group residents required a similar level of nursing care. Residents to be relocated participated in a preparation program designed to enhance their sense of control and predictability over the move. Analyses of medical records, nurses' ratings, and interviews strongly suggest that the move had no negative effect on the residents as a group or on vulnerable subgroups of residents.


The Long-Term Care Ombudsman Program: what does the complaint reporting system tell us?

Using paid staff and/or volunteers, long-term care ombudsman programs are charged with resolving complaints and solving problems that affect elderly persons in a variety of long-term care settings. This paper reports the results of a content analysis of annual ombudsman program reports sent to the Administration on Aging from 49 states in 1990. We found substantial variation in the documented information at both state and local levels and recommend revising the reporting system.


Introducing psychiatric care into nursing homes.

A consultation-liaison psychiatry program in a teaching nursing home helped implement six guiding principles including: make the patient human to the staff; assume no behavior is random; look for depression of psychosis as a source of problems; reduce medications and medication doses; create a more homelike environment; and use conditions in which learning still occurs in dementia.


Health care and consumer control: Pittsburgh's Town Meeting for Seniors.

Since 1988 two hospitals in Pittsburgh have conducted a semiannual Town Meeting for Seniors designed to provide community- based health education so that seniors can make informed decisions not only about medical care, but also about issues such as Medigap insurance, advance directives, and proper nutrition. Attendees have been predominantly white and middle class, reflecting the demographics of the surrounding area. The Town Meeting has been enthusiastically received by consumers and has led to the creation of several new community programs, including exercise classes, driver education classes, durable power of attorney workshops, and expanded insurance counseling services.


Seniors for Justice: a political and social action group for nursing home residents.

This article describes a political and social action group of cognitively intact nursing home residents. Organized in response to residents' desire to "do something" about social issues, the group is coordinated by one of the nursing home's recreational therapists, who expected participation in the group to maximize residents' autonomy and sense of control. Benefits mentioned by the participants included: the opportunity to communicate their thoughts, keeping busy, and feeling part of the larger community.


[Evaluation of the Murless head extractor].

The Murless head extractor has been used since long time ago as a vector, extractor and head rotator through cesarean section diminishing the injury feto-maternal. From march to june 1991, 50 patients with cesarean section indication and with fetus in head presentation were gotten out using this way, analyzing 12 maternal parameters and 9 fetal. The most frequent indication of cesarean section was severe Preeclampsia 41%, third cesarean section 14.7%, fetal distress 14.7%, low reserve fetal 11.7%, PROM 8.8% and others 9.1%. The height of the head was at the first plane in 59.4%. The Apgar score at the minute was of 9 in 6.0%, of 8 in 60.6%, of 7 in 18.1%, of 6 in 12.1% of 4 in 3.3%. The Apgar score at five minutes was 9 in 84.8% and 8 in 12.1% for a total of 96.9%. An USG transfontanelar was practiced in 40 products from which 37 (92.5%) were normal and in 3 (7.5%) it was found: in one brain light edema and in two hypoxical encephalopathy (caused by severe Preeclampsia, chronic hypertension and superimposed preeclampsia and fetal distress due to cord around the neck. In the other ten cases USG was not used for another reasons. Maternal morbi-mortality and general due to extractor use, was not obtained not either fetal morbi-mortality. It was concluded that the head extractor is useful, does not increase the obstetrical injury and it is easily applied).


[Indomethacin in threatening premature labor. Fetal and neonatal cardiovascular effects].

At the Hospital de Ginecobstetricia del Centro Medico "La Raza", between october 1, 1990 to may 31, 1991, were attended 50 women with premature labor, with pregnancies of 30-36 week sold. They were given 100 mg of indomethacin, rectal, daily, in order to obtain arrest of the uterine activity. The mean doses given was 4 +/- 0.739. In 26 (52%) patients there were transient, fetal ductal constriction. In these patients there were high fetal heart rate variability during the ductal constriction time. No other fetal an neonatal effects were documented. It is recommended when indomethacin was given in premature labor treatment a fetal ecocardiogram and the fetal and neonatal study of the patients in research of cardiovascular side effects, included neonatal pulmonary hypertension syndrome.


[Anticonvulsant treatment in severe preeclampsia. Comparison between diazepam and magnesium sulfate].

The objective was to compare the materno-fetal effects between Diazepam and Magnesium sulfate used as anticonvulsivant therapy in cases of severe pre-eclampsia. The study was prospective, comparative, longitudinal, randomized clinical trial. The study was done at Centro Medico Nacional Instituto Mexicano del Seguro Social. Division of Obstetrics and Gynecology, Torreon, Coah, Mexico. The patients were all the women admitted to the labor and delivery ward with diagnosis of severe pre-eclampsia and viable conceptus were assigned at random to receive either Diazepam (Group A, n = 19) or Magnesium sulfate (group B, n = 19). There were no significant differences between both groups. All of the patients remained alert, conscious and well oriented. None of the newborns showed hiporreflexia, flaccidity or neonatal respiratory distress that could be implicated to the anticonvulsivant therapy. It is concluded that Diazepam and Magnesium sulfate are good alternatives as anticonvulsivant therapy in cases of severe pre-eclampsia.


[Premature ovarian insufficiency and nuclear organizer regions in triplicate].

Silver-staining of the nucleolus organizer region, which represents transcription of ribosomal ribonucleic acid genes, was herein studied in the acrocentric chromosomes of a patient with premature ovarian failure. The demonstration of an additional nucleolar organizer region in the peripheral lymphocytes, suggests a causal relationship between transcriptive activity and this type of ovarian failure.


[Medical information system regarding the control of the results of the railroad accidents involving hazardous substances].

Medical and informational supply of the system liquidating the consequences of accidents concerning the dangerous railway goods was analysed. Emergency cards of dangerous railway goods were described as a new type of medical and technical information. 130 of such cards concerning 567 dangerous railway goods were published in 1984, additional prophylactic sections of emergency cards for 400 substances (goods) were published in 1991. Materials for 1,000 substances are prepared for publishing. Automatic system for information search was proved to have good prospects for the further development and putting into practice on railways.


[Crural blood circulation in changed position of the legs and after preventive gymnastics].

Investigations of arterial and venous circulation in the shin, analysis of work hyperemia and venous pump mechanisms have shown, that regional hemodynamics depends on the position of the lower limbs. The optimal initial position for special exercises intensifying the venous outflow is sitting with raised, slightly flexed legs, with the shin on the level of the heart. Sitting with flexed knees and vertical shin is less advisable for prophylaxis.


[Data on predicting the status of body functions of the engineering and technical personnel in the mines].

Reliability of mine foremen influences greatly the group microclimate, productivity and safety of work in mines. Engineering and technical personnel with high level of professional reliability shows the best parameters of psychophysiologic status. Criteria are worked out to score the most informative psychophysiologic functions in mine foremen during the preliminary and regular check-ups of such personnel.


[Clinical course of pneumoconiosis after exposure to dust evaluated by the results of ambulatory follow-up].

Results of follow-up and treatment of different pneumoconiosis types in 749 patients are represented. Rational employment combined with individualized treatment stabilize pneumoconiosis in 80.5% of cases with interstitial silicosis, in those with silico - silicosis --85.5% the nodular form in 70.5% and 77.8% of cases respectively. In the patients with the first symptoms of silicotuberculosisis the interstitial and nodular forms of the process stabilized in more than 50% of cases and in more than 60% of silico - silicatosis cases. Active interstitial tuberculosis was revealed in 7.3% of cases, nodular one--in 16.2%. The course of the macronodular pneumoconiosis in 50.2% of cases was unfavourable. 23.2% of patients with pneumoconiosis caused by electric-welding aerosol showed regress of pneumoconiosis in afterdust period.


[Cervical osteochondrosis in miners].

Characteristics, frequency and distribution of vertebrogenic diseases involving cervico-brachial region were studied in more than 1,000 miners from asian North and East exposed to vibration. The data were compared with the results of examination of drivers. The investigation revealed a high level of vertebrogenic cervical pain and cervico-brachial pain in miners with a long length of service, especially in those suffering from vibration disease and frequent osteochondrosis manifestation in younger age, especially in subjects working beyond the Polar Circle. Occupational hazards are proved to play a leading role in the early development of vertebrogenic diseases, and vibration disease predisposes to such pathology. The results make possible to consider the vertebrogenic cervical pain and cervico-brachial pain as occupational diseases in young-aged workers with long length of service or evaluate such diseases as complications of vibration disease in individuals facing this occupational pathology.


[Toxicological characteristics and standardization of various poly-metallic oxides].

Acute toxicity, functional cumulative and local effects of the four ++poly-metallic oxides YBa2Cu3O7, Bi4Sr3O16, Tl2Ca2Cu3O10, Lao,7Sro,3CoO3, were studied in laboratory animals. Parallel experiments on assessment toxicity of the regular oxides of the studied metals in mice were carried out. The major dissolution of metals was shown to occur in acid medium. Thallium-barium-calcium cuprite turned out to be the most toxic and cumulative; it induced the most severe morphologic changes in the liver and kidneys. The least severe disorders caused by this substance were in the rat gastric mucosa and in rabbit eye after a conjunctival injection. Yttrium-barium cuprite induced the most severe changes at the site of injection, lanthanum-strontium cobaltite ranks second here. All copper-containing polymetallic oxides show resorptive toxicity when applied to the skin. Different types of combined toxicity are possible, that is why MACs for the regular oxides can not be used for setting the normal concentrations of ++poly-metallic oxides in air. Estimated toxicometric parameters helped to score the concentrations, which may serve as tentative safe levels of the studies substances.


[Data on the standardization of a lubricant F-11 in the air of the work area].

F-11 lubricant is used in synthetic fibers industry for the polyamide fibers processing. LD50 in intragastric administration is over 11,000 mg/kg. Acute action threshold (limac) is 180 mg/m3 (as evidenced by changes of the investigatory reflex). Chronic action threshold (limch) is 100 mg/m3. MAC in the air is 5 mg/m3, hazard class III. F-11 lubricant is a moderately hazardous chemical compound.


[Biodemographic parameters as indicators of genetic adaptation to harmful occupational factors (e.g. asbestos)].

A total of 129 women working at asbestos-concentrating factories and asbestos articles manufacture plant, including 87 of them facing asbestosis and 42 exposed to asbestos without asbestosis were examined. There was no marked shifts in the reproductive function and pregnancy results of women facing asbestosis and those exposed to asbestos without asbestosis. Women facing asbestosis has infant mortality higher than other women. Parameters of potential selection (index Crow) in the studied population showed an unfavourable demographic situation in women facing asbestosis. Analysis of biodemographic data helped to suggest the possibility of genetic predisposition to asbestosis.


[A method of measuring and evaluating the changes in body temperature in humans].

Studies of thermoregulation (skin and body temperature) and heat exchange in humans engaged in physical work of different type and intensity in variable environmental temperatures provided coefficients of 'cover' and 'core' mixing to calculate the mean body temperature and changes in heat content. The derived coefficient for a certain individual depended on body cooling and on the intensity of physical work.


[Mutagenic activity of the azo dye Disperse Orange 2K and its basic component Reax dispenser].

Mutagenic activity of inhaled dispersed orange 2K nitrodye (DON 2K) and Reax' disperser was evaluated. Chronically inhaled DON 2K (with disperser) in concentration 28.6 mg/m3 is a genetic danger for an individual and population, being also a selective by injurious++ to the red blood cells. Chronically inhaled Reax' disperser (25.7 and 5.8 mg/m3) shows low mutagenic activity in somatic tissue. Thus, the mutagenic effect of DON 2K with disperser (composition is constant) is explained by nitrodye and not a disperser.


[Problem of predicting occupational morbidity among workers in the iron ore mines of the Krivoĭ Rog region].

The article represents the morbidity prognosis of silicosis, dust bronchitis, cochlear neuritis, vibration disease, trinitrotoluene cataract. Only the morbidity prognosis of silicosis proved to be stable, because the objective diagnosis makes its level close to true.


[Gas-chromatographic analysis of the fungicide azocene in environmental objects and biological specimens].

Sensitive gas chromatography methods have been worked out for evaluation of azocene trace quantities in the air of working and populated area, water, soil, plants and biological material. Chromatographer with thermoionic detector was employed. The lower detection threshold is 2 ng of azocene. The resulting errors is under 20. Other fungicides do not interfere.


[A case of extrinsic allergic alveolitis in a shoe factory worker].

The article describes one case of exogenic allergic alveolitis (EAA) developed in female engaged into shoe-making during 20 years and exposed to high concentrations of industrial multicomponent aerosols. Having pneumonia-like exacerbations, the disease demonstrated growing dyspnea and intercurrent pulmonary infiltrations. Such diagnoses as pneumonia, pulmonary tuberculosis, Loeffler syndrome, pulmonary sarcoidosis and EAA were discussed. The diagnosis of "shoe-maker's" EAA was based on the features of anamnesis, occupational life and manifestations confirmed by immunologic and morphologic data. Endobronchial lavage with hydrocortisone administration was proved to be effective. The importance of clinical and immunologic criteria, examination of ability to work in people suffering from EAA was stressed.


[Polarographic analysis of cobalt in biological specimens].

References to different methods of cobalt detection in biologic material are given. Polarographic detection of cobalt in human urine and animal biologic material worked out by authors was used for evaluation of biologic MAC. Biologic material was limed by nitric and sulfuric acids. Sulfuric acid was carefully distilled off the burnt material. Mineralized material was dissolved in 10 ml of 1N hydrochloric acid, filtered and again steamed into moist salts. 2.5 ml of water, 0.5 ml of dimethylglyoxime (0.02 M), 2 ml of Na4P2O7 (0.2 M) and 5 ml of buffer solution (0.1 M NH4Cl and NH4OH) were added to limed mineral, than pH was driven to 9 by 1 = 2 drops of ammonia solution and after blowing through, the specimen was exposed to polarography in alternating current. ++Redox potential of cobalt is 1.18 V. The method can be used for detection of cobalt in urine of workers contacting with the stated metal. Sensitivity of the method is 0.02 Mkg/ml.


[Mean temperature of the human body in various thermal conditions].

A more precise method to score the mean temperature of human body exposed to a wide range of heat was worked out. The work produced formula describing the correlation between the changes of mean body temperature and human thermal status, which lets score the degree of overheating and/or cooling from heat content.


[Physiological and hygienic substantiation of the resting time for transportation workers in the mining industry in relation to the workload and meteorological conditions].

Heat status was examined in machine open-cast mine extracting workers of Armenia to establish the prophylactic measures against overheating for optimal thermal status of the body. At the end of the working shift during the warm season machine workers showed the strain of heat status demonstrated the necessity of the additional 20 minutes rest after the 2nd trip during the warm season. Traditional drinks can be recommended to compensate for marked loss of moisture.


Hemostatic effect of platelet von Willebrand factor.

In type III von Willebrand disease (vWD) patients, the bleeding time was only partially corrected or not modified after cryoprecipitate infusion, although the levels and the multimeric structure of plasma von Willebrand factor (vWF) were normal. However, the adhesion of normal platelets on the vessel wall subendothelium in the presence of postinfusion patient plasma improved more significantly than the bleeding time. These results suggest a role of the vWF released from normal platelets which is absent in type III vWD platelets. In 5 patients transfusion of normal platelet concentrates performed 1 h after cryoprecipitate infusion without modification of the bleeding time (> 30 min) normalized this parameter, and platelet adhesion to the subendothelium elicited a marked improvement. These last results confirm the suggestion that platelet vWF plays an important 'in vivo' role in the hemostatic process, particularly in patients suffering from severe vWD.


von Willebrand's disease in Scandinavia and on difficulties in diagnosing von Willebrand's disease type I.

The research on von Willebrand's disease performed in Sweden and Finland since the late 1920s is reviewed. The difficulties in diagnosing mild von Willebrand's disease, due to intra-individual variability, is discussed in relation to making correct pedigrees for genetic studies. As shown by some examples, new techniques for genetic studies will eliminate such difficulties and lead to better understanding of the pathogenesis.


Haemophilia home therapy.

Within the past 20 years, home therapy has become an accepted treatment for the majority of people with severe haemophilia in the developed world. The intravenous administration of blood products by suitably trained patients or their relatives has proved to be safe and effective. It allows for the early treatment of bleeding episodes before the appearance of physical signs. It results in reduced morbidity, especially in terms of reduction in long-term arthropathy, and in reduced socio-economic handicap. It is cost effective both in terms of savings in time previously lost from school or work and reduction of reliance on expensive hospital facilities. Home therapy forms a vital part of the overall comprehensive care of people with haemophilia and their families.


Long-term therapy and on-demand treatment of children and adolescents with severe haemophilia A: 12 years of experience.

Between 1978 and 1989, a controlled study was performed on children and adolescents suffering from severe haemophilia A. Special attention was given to long-term therapy adjusted to the patients' requirements. The clinical and the X-ray scores of the Orthopaedic Advisory Committee of the World Haemophilia Society were used to assess the orthopaedic findings. The present investigation is a 12-year follow-up study of 90 patients affected with severe forms of haemophilia A. All knee and ankle joints of the patients were evaluated. After 12 years, the clinical scores remained unchanged or had been improved (knees 94%, X-ray score 97, ankles 86, X-ray score 88).


Update of 156 episodes of central nervous system bleeding in hemophiliacs.

Between 1960 and 1991, 156 episodes of central nervous system (CNS) bleeding were documented in 106 patients from a total population of 1,410 hemophiliacs (7.5%). Ninety-one hemophilia A patients presented 131 bleeding episodes; 15 hemophilia B patients had 25 episodes. 32% of these episodes took place in patients less than 5 years of age. 46% were age 10 or less, and 72% were age 20 or less. The mean age was 14.8 years in hemophilia A and 9 years in hemophilia B patients. A significant increase in the mean age of hemophilia A patients has been observed over the last 10 years; this may be related to HIV infection. A history of recent trauma was documented in 39.7% of the episodes. Spontaneous CNS bleeding was predominant in severe hemophilia (85.2%). One hundred and fifty-four CNS bleeding episodes were intracranial and 2 intraspinal. Of the intracranial episodes, 37.7% were subarachnoid, 29.8 subdural, and 22.7% intracerebral. Factor VIII or IX inhibitors were present in 11.3% of the patients; this figure is slightly lower than that observed in our total hemophilic population. Over 50% of the patients had psychoneurological sequelae; the most frequent were seizure disorders and motor impairment. The overall mortality rate was 29.2%. The mortality was more closely related to the CNS bleeding site than to the severity of hemophilia. Treatment should be based on prompt and prolonged replacement therapy to ensure hemostatic levels of antihemophilia factors.


Management of factor VIII inhibitors: evolution and current status.

Management of patients with factor VIII (and IX) inhibitors includes management of acute bleeds and methods to induce immune suppression and tolerance and to detect patients at risk of developing inhibitors. The methods used over the years to treat acute bleeding have been more or less successful. The best method is to raise factor VIII levels by human or porcine factor VIII concentrate, but this is not usually possible. Prothrombin complex concentrates, activated or non-activated, have enjoyed some success as factor VIII by passing agents, but the development of recombinant activated factor VII represents a new and promising method of inducing haemoslasis at the site of bleeding whilst minimizing the risk of disseminated intravascular coagulation. Alternatively, the use of tissue factor is under consideration to exploit the extrinsic system. Methods to induce immunological tolerance by use of the 'Bonn' regime or by the introduction of immunomodulation with the 'Malmö' regime of extracorporeal immunodepletion, cyclophosphamide, and intravenous immunoglobulin continue to be attempted with significant but variable success. Gradually the inhibitor problem is being contained, but it is still an important complication of haemophilia therapy.


Desmopressin: a nontransfusional treatment of hemophilia and von Willebrand disease.

Desmopressin (1-deamino-8-D-arginine vasopressin) is a synthetic analogue of the antidiuretic hormone L-arginine vasopressin. Because it can raise circulating levels of factor VIII and von Willebrand factor, desmopressin is used for nontransfusional treatment of mild and moderate hemophilia and von Willebrand disease. Desmopressin also shortens the prolonged skin bleeding time in patients suffering from von Willebrand disease and is given to prevent or stop excessive bleeding in such conditions.


Financial assistance for HIV-infected persons with haemophilia worldwide.

In many countries we could note the dramatic developments in regard to financial assistance of HIV-infected haemophiliacs and their families since we distributed the first overview on this to all World Federation of Hemophilia member countries. As a result of the untiring efforts of the National Haemophilia Societies, infected persons and their families receive essential assistance in 15 member countries. It is hoped that this development will sway more and more member countries to consider demands for financial support and provide them with the arguments to succeed.


La Paz Hemophilia Center, 1967-1992: people, events, and memories.

In 1967, once urgent blood requirements had been resolved in La Paz Hospital, Madrid, Spain, and adequate supplies of plasma for cryoprecipitation, therefore, being available, a Hemophilia Unit (later Hemophilia Center) was set up to attend to the comprehensive care of hemophilia patients and patients with other coagulopathies. This Center covers a regional area and also a national area for referrals and normally attends 600 patients. In this Center the Spanish Social Security Hemophilia Association was created. In 1983 the first cases of AIDS appeared, occasioning the change from standard factor VIII concentrates to the heat-treated concentrates that had recently appeared on the market. At present the Center is responsible for the medical attention of those hemophilia patients affected by HIV.


Diagnosis of Glanzmann's thrombasthenia and carrier detection using monoclonal antibodies to platelet glycoprotein IIb and IIIa in immunoblotting.

Glanzmann's thrombasthenia is a rare hemorrhagic syndrome, characterized by a quantitative or functional defect of the platelet glycoprotein GPIIb-IIIa complex. The authors describe a method to diagnose thrombasthenic patients and identify carrier subjects by using monoclonal antibodies specific for GPIIb and GPIIIa in an immunoblotting technique. The immunoreaction patterns of two thrombasthenic patients lacking GPIIb or GPIIIa, respectively, are shown. The described method produces further evidence concerning the biochemical heterogeneity of Glanzmann's thrombasthenia.


Elevated levels of plasma and urine beta-thromboglobulin or thromboxane-B2 as markers of real platelet hyperactivation in diabetic nephropathy.

Serum creatinine, immunoreactive serum and urine beta 2-microglobulin, plasma and urine thromboglobulin, plasma thromboxane-B2 levels and daily protein excretion were determined in 61 insulin-treated diabetic patients, comparing the different patient groups (complication free, nephropathy without and with azotaemia) with control subjects. In the groups of diabetic patients, plasma and urine beta-thromboglobulin (BTG) and plasma thromboxane-B2 levels were higher than in the controls. There was a significant positive correlation between urine BTG and beta 2-microglobulin in the group without complication, and between the plasma BTG and beta 2-microglobulin, and plasma BTG and thromboxane levels in the diabetic group with azotaemia. In contrast to some previous assumptions, the increased level of plasma BTG reflects a real platelet hyperactivation in patients with diabetic nephropathy. At the same time, urine BTG also increases. Determination of urine BTG is more simple with less possibility of methodological error.


An experiential program to reduce AIDS risk among female sex partners of injection-drug users.

This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.


Connecting the disconnected: adult day care for people with AIDS in New York City.

Despite pressing need, the development of a continuum of long-term-care services for people with acquired immune deficiency syndrome (AIDS) has been hampered by the dearth of information on the characteristics and service needs of patients eligible for such care. This article presents findings from a process evaluation of an outpatient day care program for people with AIDS in New York City. The AIDS clients were highly functional but had a diverse range of needs and problems related to housing, substance abuse, medical care, and social support. The majority of clients reported being very satisfied with the level of staff support and with the overall program. The findings of the study suggest that day care is a valuable addition to the continuum of services and that the creative dissemination of this program may improve the delivery of services to people with AIDS.


Caregivers of elderly relatives: spouses and adult children.

A problem in the provision of home health care for elderly people is the limited number of family members available for caregiving. Current trends in federal, state, and local policy formation suggest an increasing emphasis on the family as an appropriate caregiver. Therefore, it is necessary to examine how family relationships affect the caregivers' responses to their caregiver situation. Data are presented from 206 caregivers enrolled in a larger longitudinal study of family members caring for elderly dependent relatives. The sample is divided into four caregiver groups: (1) spouses who have children, (2) spouses who have no children, (3) adult children who have siblings, and (4) adult children who have no siblings. Measures selected for comparison were perception of burden, caregiver involvement, affective social support, mental health status, and use of community services. Differences were found among the four groups of caregivers. Implications for social work intervention are discussed.


Evaluating social work discharge planning services for elderly people: access, complexity, and outcome.

The discharge planning role of hospital social workers has become increasingly important in services to elderly people. This article examines three issues: (1) the extent to which elderly people most in need receive social work services, (2) the extent to which the discharge planning performed is a professional task, and (3) the effectiveness of discharge planning for those who return to their homes after hospitalization. The study focused on 1,100 elderly patients from five Baltimore hospitals. Data were gathered from their social workers, from the patients themselves (by phone after discharge), and from medical records. Results show that only a minority of elderly patients who return to the community after hospitalization receive social work services while in the hospital but that those who do are likely to have posthospital needs. In most cases, the discharge planning uses professional skills, but 28 percent of cases are fairly routine. Finally, social work services were effective in reducing the level of unmet needs in the areas of nursing, medication, and physical therapy.


Clinical decision making for discharge planning in a changing psychiatric environment.

This article reviews the clinical decision-making process involved in planning for continuity of care following discharge from inpatient psychiatric services. The decision-making frame of reference requires the identification of the players in the process, parameters of their roles, performance expectations, and boundaries of rights and obligations; clear definition of objectives; collection of data and analysis of its relevancy; and study of possible alternatives, with evaluations of their consequences. The authors present an approach to clinical decision making that includes an analysis of modalities and practice skills and a critical review of practice in a psychiatric setting that emphasizes the role of the family; the importance of continuity of care; and the need to engage the patient, family, and care systems within briefer time frames.


Morphometric ultrastructural evaluation of secondary oocytes of mice receiving vincristine.

Secondary oocytes from mice receiving vincristine in amounts corresponding to therapeutic doses in human, in neoplasm treatment, were evaluated morphometrically and ultrastructurally. In the group of animals treated with vincristine an increase of the volume fraction of vesicular complexes and a decrease of the volume fraction of fibrous material were observed. It has also been demonstrated that, in secondary oocytes from mice receiving vincristine, the number of both multivesicular bodies and vesicles falling to one vesicular complex profile was higher than in the control group. The present results suggest that vincristine applied to females, even in therapeutic doses, may affect egg cells.


Submicroscopic studies on adrenaline secretion from adrenal epinephrocytes.

Some cellular mechanisms governing the secretion of adrenaline by epinephrocytes of guinea pigs sacrificed because of acute anaphylaxis produced by inhalatory administration of ovoalbumin following sensitization with this antigen have been studied. In acute anaphylaxis the adrenaline secretion from epinephrocytes occurs mainly by massive and facilitated exocytosis mechanism that differs from the classical exocytosis one. Increase in the concentration of ionized calcium, increase in the number of microtubules, and decrease in the number of microfilaments in the epinephrocytes have the essential significance in the mechanism of this secretion.


Early development of the mesencephalic nucleus of the trigeminal nerve in human embryos (stages 14 and 15).

The mesencephalic nucleus of V was investigated in embryos of developmental stages 14 and 15. In stage 14 the nucleus is formed by a small group of cells lying a little rostrally to the sulcus limitans in the pontine flexure. In stage 15 the cells of the nucleus are also found in the anterior crus of the pontine flexure. The nucleus is composed of oval cells resembling those of the trigeminal ganglion.