Obstetrical condition and neonatal neurological outcome in Dominica, the Caribbean. A comparative study. Risk factors during pregnancy and delivery and neurological morbidity of newborns were assessed in a birth cohort in Dominica, the Caribbean. The data were compared with two reference groups, one from Grenada, the Caribbean, and the other from Groningen, the Netherlands. Despite variations in cultural and socio-economic situation, the similarities in obstetrical conditions, neonatal neurological morbidity and perinatal relationships between the three groups were more striking than the differences. The Dominican group showed a significantly higher rate of preterm births than the two other groups. Preterm birth was associated with a significant increase in neurological deviancy. In general motility and muscle tone were found to be lower in the Caribbean region than in the Netherlands.


Severe falciparum malaria: survival with oral therapy. A case of severe falciparum hyperparasitaemia with trophozoites in greater than 35% of the patient's erythrocytes, relative lack of clinical symptoms and no organ complication is described. The patient, a 26-month old African child, was treated with oral mefloquine with prompt clearance of fever and parasitaemia in 24 and 48 hours respectively. No untoward sequelae was observed during 75 days of periodic clinical assessment.


Isolation of Entamoeba histolytica from arthritic knee joint. Amoebae were isolated from an arthritic knee of a male patient. The organisms grew in Egg Yolk Infusion medium, and in Diamond's Biosate Iron-Serum-33 medium, which contained Trypanosoma cruzi, and were identified microscopically as Entamoeba histolytica. Furthermore, amoebae-like organisms in aspirate and cultures were immunocytochemically identified using monoclonal antibodies against E. histolytica. On the basis of the morphologic and immunologic observations, it was concluded that the knee lesion was caused by infection with E. hystolytica. The knee lesion resolved following treatment with metronidazole. This case is the first report of an amoebic infection of the knee joint.


Pasteurella multocida infection in Singapore. A case of Pasteurella multocida infection in Singapore is presented. The patient was a 21-year-old Chinese male who developed fever and cellulitis with abscess formation of his right index finger after it was bitten by a stray cat. The organism was isolated in pure culture and identified as Pasteurella multocida subspecies septica. The patient responded to antibiotic therapy and had an uneventful recovery.


The association of infective hepatitis type A (HAV) and diabetes mellitus. The cases of three patients who developed diabetes mellitus (DM) within 2-3 weeks of acute hepatitis A virus (HAV) infection associated with diabetic ketoacidosis are reported. The ketoacidosis was considered an index of insulin dependent diabetes mellitus most likely precipitated by the acute virus infection.


IgA nephropathy (IgAN) presenting with the nephrotic syndrome. A 20 year old Nigerian male with the nephrotic syndrome was found to have IgA nephropathy (IgAN) on renal biopsy. The renal function at presentation was normal and his nephrotic syndrome initially responded to steroid therapy. However, significant deterioration in renal function was noticed 2 years later when his nephrotic syndrome relapsed. This is the first documented case of IgAN in a Nigerian. Considering the rather low renal biopsy rate in this environment, a number of cases with this nephropathy may be missed.


A critical study into the fecal analysis routine in practice in Jordan. The fecal analysis routine adopted by 21 diagnostic medical laboratories in Jordan was surveyed by the means of a questionnaire filled in by the senior year medical technology students who spent 16 weeks in these laboratories as trainees. The recommended routine fecal analysis was not completed satisfactorily by any of the laboratories surveyed. The wet mount microscopic examination was the sole technical test done for the examination of parasite and ova by the majority of the laboratories, 90% (19 of 21). None of the surveyed laboratories adopted the routine use of a concentration technique. One hundred and eight known positive stool specimens were examined by four qualified medical technologists. The wet mount technique revealed positivity in 53% of specimens only, while the formol-ether sedimentation technique yielded 98-100% positivity. This indicates the value of the formol-ether sedimentation technique over the practiced wet mount technique in the routine fecal analysis.


Alkohl use in Saudi Arabia. Extent of use and possible lead toxicity. The extent of alkohl use, its lead content and blood lead levels after use were investigated. A total of 500 individuals were interviewed. It was observed that 233 (47%) had used alkohl. The main purposes for its use were: eye cosmetic (66%) and eye and umbilical stump remedy (26%). Of those who used it as an eye cosmetic, 45% applied it daily and 18% occasionally. Sixty-five (28%) of the users experienced some type of adverse reactions. Their mean blood lead levels was 0.99 uMol/L as compared to 0.26 uMol/L in non-users. The majority of alkohl samples analyzed had high lead content. Mean blood lead levels of rabbits treated with alkohl was 3.31 uMol/L. It is recommended that the public should be educated on the possible dangers of continued alkohl use.


Prevalence of hookworm species in Pondicherry, India. A study was carried out to find out the hookworm species prevalent in Pondicherry, India, based on the identification of filariform larvae recovered from coproculture of hookworm positive stools. A total of 184 hookworm positive stools were cultured using the Harada-Mori coproculture method. The results of the study for the first time showed both hookworm species, Ancylostoma duodenale (60 cases) and Necator americanus (49 cases) to be present in Pondicherry. The former species was relatively more common than the latter. Three cases were infected with both species of hookworm.


[The 3-dimensional organization of the nucleolus and the nucleolus organizer regions in differentiated cells. II. The reticular, vacuolized and nucleolonemal nucleoli of hepatocytes from the intact mouse liver and of hepatocytes stimulated to proliferation as a result of partial hepatectomy]. By means of stereological and morphological analysis, the dynamics of nucleolar structural changes in stimulated mouse hepatocytes has been studied. Reticulated and vacuolized nucleoli typical for normally functioning hepatocytes were shown to convert into the nucleolonemal nucleoli, first noticed 18 hours following operation. The process of activation of mouse hepatocyte nucleoli involves two steps. At the first step (within 1-18 hours following operation) a progressive growth of nucleoli volume, due to a simultaneous reduction of vacuolar sizes and growth of RNP component occurs. Such changes were observed in both groups of nucleoli being present in the intact mouse liver, because at this particular step a considerable decrease in the number of vacuolized nucleoli took place. Besides, in the stimulated hepatocyte nucleoli the number and total volume of fibrillar centers increase. However, in spite of their considerable changes, the nucleoli preserve the marks characteristic of the reticulated type. The second step of activation, noted 18 hours after stimulation of hepatocytes, includes more fundamental structural reconstructions. As the result, reticulated nucleoli obtain the nucleolonemal structure. At the same time, on the background of a further decrease in the individual volume and an essential growth of the total volume in the fibrillar centres, a spasmodic increase in the mass of the dense fibrillar component, which is associated with the formation of the continuous strand of the nucleolonema. All this is responsible for the complete changes in structural organization of nucleoli commonly seen in mouse hepatocytes. It is suggested that the cause of such a structural reconstruction may be due to the changes in topography of transcriptionally active regions of rDNA.


[The 3-dimensional organization of the nucleolus and the nucleolus organizer regions in differentiated cells. III. Changes in the nature of the distribution of argentophilic proteins in the nucleoli of mouse hepatocytes with stimulation of the hepatocytes to proliferation]. The stereological and morphological analysis of Ag-positive zones revealed the principal difference in quantity and distribution of Ag-NOR proteins in reticulated and nucleolonemal nucleoli of mouse hepatocytes. It is shown that reticulated nucleoli of resting hepatocytes are characterized with the presence of discrete rounded Ag-positive zones, whose quantitative parameters correspond to the fibrillar centers and dense fibrillar component taken together. The analysis of the three-dimensional structure of Ag-positive zones of nucleolonemal nucleoli has revealed considerable changes in quantity and distribution of Ag-NOR proteins due to proliferative stimuli. 22 hours following operation, a continuous, strongly winding strand of nucleolonema is revealed in the nuclei. Taking into account that Ag-NOR proteins are associated with the transcriptionally active regions of rDNA it may be suggested that this structural conversion was due to decondensation and activation of inactive regions of r-chromatin. A considerable growth of Ag-positive zone volume during the conversion of reticulated nucleoli into the nucleolonemal type may be explained by the increase in Ag-NOR protein contents.


[The molecular organizational characteristics of the cell nucleus components at different phases of the mitotic cycle and in the resting state]. Data about the changes of the cell nucleus structure at different levels of its organization are summarized in the review. The data about the change of the DNA break number during the cycle and in resting state are presented and the role of the changes of the repair efficiency in this process is discussed. The changes of the chromatin protein spectrum, the chromatin structure at nucleosomal and supranucleosomal levels, the DNA superhelicity, topoisomerase activity, nuclear matrix composition and structure are discussed as well. The nucleus structure during the S-phase and mitosis and the cycle-related changes of the chromatin structure in lower eukaryotes are reviewed separately.


[The regulation of the DNA repair process in mammalian cells. IV. The role of DNA polymerases in the epidermal growth factor regulation of the repair of single-stranded DNA breaks induced by ionizing radiation in Swiss 3T6 mouse cells]. A study was made of the repair of ionizing radiation-induced DNA single-strand breaks (SSB) in proliferating and quiescent mouse Swiss 3T6 cells and in those stimulated from the quiet status by epidermal growth factor in combination with insulin, in the presence of specific inhibitors of DNA polymerase alpha and delta (aphidicolin) and DNA polymerase beta (2', 3'-dideoxythymidine-5'-triphosphate). The repair of DNA SSB induced by X-ray-irradiation (10 Gr) or by gamma-ray irradiation (150 Gr) is more sensitive to aphidicolin independently of cell proliferating status. Aphidicolin inhibits the recovery of single-strand DNA in quiescent and mitogen-stimulated cells three times stronger than in proliferating cells. The influence of 2', 3'-dideoxythymidine-5'-triphosphate on the rate of DNA SSB repair in cells of all the three types does not differ. Thus, the decrease in DNA repair efficiency in quiescent cells is connected with a decrease in the activity of aphidicolin-sensitive DNA polymerase, apparently DNA polymerase alpha. It is suggested that the regulation action of mitogens on the DNA SSB repair may be determined by qualitative changes of this enzyme or of some conditions in which it functions. The involvement of DNA polymerase delta in this process is not excluded.


[A glutathione deficiency in open-angle glaucoma and the approaches to its correction]. A total of 151 patients with open-angle glaucoma, 23 ones with closed angle glaucoma, and 57 ones with age-associated cataracts were examined. The reference group consisted of 21 subjects with posttraumatic cataracts (1.5 years after the injury) and normal subjects. Nonprotein sulfhydryl groups (glutathione) were measured in the peripheral blood, aqueous humor, and in tissue samples from the scleral drainage sites, obtained in antiglaucoma surgery and in surgery for cataract extraction. Aqueous humor of patients with posttraumatic cataracts, blood samples of these patients and normal subjects were examined for control. The level of sulfhydryl groups was found significantly lowered in the anterior chamber humor of patients with open-angle glaucoma, particularly in those with disease Stages II and III as against the controls. The content of sulfhydryl groups was lowered in the tissue samples from the scleral drainage area of patients with open-angle glaucoma Stages II and III vs. that in the patients with Stage I condition. Similar changes were found in the red cells of patients with Stages II and III open-angle glaucoma. Glutathione is an important component of the cellular antioxidant system. The findings point to a reduction of the processes of antioxidant defense of ocular tissues, developing as early as in the first stage of open-angle glaucoma. Lipoic acid administration for 2 months was associated with a rise of glutathione level in the red cells of patients with Stages II and III open-angle glaucoma.


[Transcutaneous electrostimulation of the primary elements of the visual system in children after the extraction of a congenital cataract]. Courses of transcutaneous electrostimulation of the visual analyzer periphery according to E. B. Kompaneets were administered to 31 children (56 eyes) aged 4 to 12 because of low vision acuity after congenital cataract extraction. The amplitude of stimulating pulses was from 150 to 400 microA. The first course consisted of 5-8 sessions, repeated courses of 4 sessions. The results were assessed by vision acuity check-ups and recordings of visual [correction of auditory] evoked potentials (AEP). Vision acuity improved from 0.1 to 0.9 after a course of treatment. AEP amplitude was reduced in all the patients to 15.4 microV on an average, the time of the pulse conduction in the auditory system was normal (113.2 ms). Electrostimulation effects on the AEP were negligible. Electrostimulation may be recommended to children with low vision acuity and low values of the AEP amplitude after congenital cataract extraction.


[The use of new scleroplastic materials in the surgery of traumatic retinal detachment]. New textile-based material is suggested for scleroplastic surgery for detachment of the retina. Features of the design of the new material are described and the efficacy of the implants assessed. Textile-based implants are recommended for clinical practice.


[The dynamic indices of local blood circulation in the surgical treatment of retinal detachment]. The hemodynamics of both eyes was examined before and after surgery in patients with detachment of the retina. The depression of uveal blood stream was transitory in extrascleral ballooning, in contrast to that in cerclage and filling, when the hemodynamic characteristics of both eyes are significantly reduced.


[The hemodynamics of the brain and eye in patients with presenile and senile nonexudative central chorioretinal dystrophy during health resort treatment]. Rheographic studies of the cerebral and ocular hemodynamics carried out in patients with presenile and senile nonexudative central chorioretinal dystrophies over a 26-day course of multiple-modality health resort treatment revealed left-side asymmetry of the earlier and more marked injuries of the ocular membranes and the carotid system, a low rheographic index of the carotid system as early as in the first stage of the disease. The findings evidence improvement of the brain and eye hemodynamics in the course of treatment, this being conducive to improvement of the ocular function during all stages of the disease. The most dynamic parameters were the rheo-ophthalmographic coefficient in the patients with all stages of the disease and the rheographic index of the central cerebral artery in those with Stages I and II maculodystrophy. Assessment of these parameters in the course of health resort therapy of the retinal conditions mentioned will help assess the treatment efficacy.


[The effect of trental and actovegin on the organs of vision when administered into the end periorbital branches of the ophthalmic artery (experimental research)]. Specific features of the delivery and the possible side affects of intraarterial infusions of trental and actovegin on the retina, vessels, and the optic nerve in administration of these drugs into the peripheral periorbital branches of the orbital artery were under study. Contrast angiography and fluorescent angiography have confirmed in all the cases the correctness of the catheter position and its functional competence, as well as the possibility of rapidly creating the necessary concentration of the drugs in the retinal and choroidal vessels for a sufficiently long time. Electroretinogram recording before and after intraarterial infusions of the before drugs has demonstrated the functional intactness of the retina, and morphologic studies have shown the absence of any injurious effect of the drug on the organ of vision in such a method of administration. Results of experimental trials permit recommending starting the clinical trials of the intraarterial infusion of trental and actovegin into the periorbital branches of the orbital artery.


[The immunological factors characterizing neurochorioretinitis]. Comprehensive clinical and immunologic studies carried out in 38 patients with neurochorioretinitis have demonstrated the contribution of infection to the etiology and pathogenesis of this condition and helped identify the nature, mostly infectious, of the condition in 55.3% of patients. Toxoplasma infection, revealed in 39.5% of cases, is one of the major etiologic factors of neurochorioretinitis. Tuberculous etiology of the condition is more rare (7.9% of cases). The autoimmune systemic component was detected in 7.9% of the examinees. Immunopathologic shifts, presenting as hyperimmunoglobulinemia, were fairly frequent (71.9% of patients), excessive concentrations of circulating immune complexes were detected in 78.6% and cryoglobulins were found in 42.9% of the examinees, this permitting the authors to regard neurochorioretinitis as a form of immunocomplex conditions of the eye, most possibly, of an infectious origin. Blood group A (II) was found to be a risk factor for neurochorioretinitis patients; according to the literature data, this is explained by a reduction of the interferonogenic activity. Etiotropic anti-inflammatory drugs, including corticosteroids, and interferon preparations for the risk group patients appear to be advisable for the therapy of neurochorioretinitis.


[Panoramic zonography in the diagnosis of orbital fractures]. A total of 453 patients with acute injuries of the upper and median zones of the facial skull were examined. The most frequent injury was that to the orbital entrance, fractures of the inferior wall; fractures of the exterior, interior, and anterior walls were less incident, and fractures of the orbital apex were the most rare. Types of the skull bone fractures, associated with injury to the orbital walls, were distinguished. The x-ray semeiotics of injuries to the orbital walls was specified making use of panoramic sonography. Panoramic zonography [correction of sonography] with the use of the Zonark [correction of Sonarc] apparatus helps identify the volume and extension of the injuries on all the orbital walls and is altogether an effective method for the diagnosis of the orbital wall fractures.


[The involutional vitreoretinal syndrome]. Ocular changes in elderly subjects are described, that may be regarded as manifestations of a disease, denoted by the author as the involution vitreoretinal syndrome. The subjective signs of the syndrome are floating 'moths', photopsias presenting as a 'lateral lightning', sudden appearance of a central macula (central positive scotoma). The objective signs are destruction and posterior detachment of the vitreous body, peripheral retinal dystrophy, stable light reflexes (coin-shaped, flap, etc.) on the fundus oculi, previously described by the author. The syndrome complications are fibroplasia of the fundus oculi central area, macular edema, perforation of the macula and characteristic lenticular changes. The author singled out the cases with combined changes of the vitreous body, fundus oculi and lens involvement as a lentivitreoretinal form of the involution vitreoretinal syndrome.


[The dependence of the cortical topography of visual evoked potentials on the stimulation frequency]. Cortical topography of steady-state flash visual evoked potentials (fVEP) was compared with topography of transient fVEP and pattern VEP (pVEP) in 17 normal subjects. It was found that at low (up to 20 Hz) frequencies fVEP demonstrate extensive dissemination on the scalp. At higher frequencies (30 Hz or higher) fVEP were registered mostly in the occipital area similarly as transient pVEP. These results suggest that the neural structures responsible for the generation of transient pVEP and steady-state fVEP of 30 Hz and higher frequencies are anatomically identical.


[Pathological mineralization in retinoblastoma]. Calcium phosphate, fluoroapatine mineral, Ca5(PO4)3F, characterized by a strong reflex in interplanar distance d = 2.789 A, were identified in the tissue of retinoblastoma by x-ray destructive analysis. The strong reflex intensity and the respective fluoroapatite level in the tumor are the higher, the more malignant the tumor is. The malignancy degree is determined by histologic analysis of the tumor cellular composition after enucleation.


[The laser correction of recurrent elevated intraocular pressure after a surgical operation to control glaucoma complicated by the blocking of the postoperative fistula by the root of the iris]. Laser intervention was carried out in 18 patients (18 eyes) with open-angle glaucoma and decompensated intraocular pressure, that developed in 2 weeks--5 years after primary antiglaucoma surgery. Developed glaucoma stage was diagnosed in 16 eyes, in 2 eyes far-advanced condition was found. Blocking of the fistula by the iridal root was responsible for the inefficacy of fistulizing surgery. Laser trabeculoplasty to compensate for the intraocular pressure was carried out in 18 eyes, in 9 eyes this treatment was combined with gonioplasty. Stable normalization of intraocular pressure was observed in 13 eyes in remote periods after laser coagulation. Analysis of the results has brought the authors to a conclusion that the administered laser trabeculoplasty as an individual treatment modality and in combination with gonioplasty is fairly effective, results in prolonged compensation of the ophthalmic tone, and is altogether less traumatic than repeated surgery.


[Ocular function in beta-thalassemia patients]. The eyes were examined in 118 inpatients with various thalassemia forms. The examinations included viso- and perimetry, biomicro- and ophthalmoscopy, fluorescent angiography of the fundus oculi and retinophotography. Patients with thalassemia were found to develop a variety of changes in the eye, whose manifestations depended on the length and severity of the underlying disease and on the treatment administered. Changes in the conjunctival and retinal vessels develop as early as in the initial stages of thalassemia, presenting as twisting, dilatation, and irregular calibre of the veins, dilatation of the arteries and reduction of their light reflex. Later dystrophic and atrophic changes develop: obliteration of the iris pattern and thinning of its peripheral zone, deterioration of blood circulation in the central retinal zone. Multiple blood transfusions and hemosiderosis lead to the development of hyperpigmentation of the limb, sclera, fundus oculi and appearance of retinal angioid strips. These findings should be taken into consideration when assessing the ocular status of thalassemia patients and defining the indications for treatment for angiopathic and dystrophic processes in the eye.


[The clinico-morphological characteristics of the annular form of iridociliary neoplasms]. The authors present the results of clinical and morphologic analysis of 10 cases with annular iridociliary tumors that occurred within the latest decade. The incidence of this tumor among other intraocular tumors has been 3.7%, that among iridocialiary tumors, 42.8%. In seven of the ten patients the disease manifested by elevation of intraocular pressure, less frequently it manifested by changed color of the iris or acute iridocyclitis. Extrabulbar tumor growth into the scleral conjunctiva was observed in half of the patients, in two of these lymphogenic metastases were detected. The prolonged latent course of the disease impeded in the majority of cases not only timely diagnosis of the intraocular tumor, but of its dissemination as well. Four histologic variants of the tumor growth were distinguished.


[The optimization of a method of local anesthesia in glaucoma-control operations]. Revising his own experience, the author comes to a conclusion that instillation and subconjunctival anesthesia is sufficient for painless antiglaucoma surgery. Retrobulbar anesthesia and eyelid akinesia are justified only in rare cases. Use of the bridle suture is indicated only for surgery of the patients with a narrow lid slit and deeply sunk eyeball.


[The influence of the fixation of the scleral flap on the hypotensive effect of trabeculectomy]. The author analyzes 60 trabeculectomies with fixation of the superficial scleral flap by three nodular sutures (n = 24) and by one nodular suture (n = 36). He comes to the conclusion that trabeculectomy with scleral flap fixation by one nodular suture is preferable to its fixation with three sutures, for it creates better conditions for the formation of filtration pad and provides a more stable hypotensive effect, as evidenced by the results of three-year follow-up (75% vs. 41.6%). Nonetheless the author claims that fixation of the scleral flap with 3-4 sutures is desirable in cases when filtering trabeculectomy variants are deliberately employed or when trabeculectomy modifications with uveoscleral discharge stimulation are used.


Causes of lamb morbidity and mortality in the Ethiopian highlands. A study was conducted to investigate causes of lamb morbidity and mortality on farms and on-station at Debre Berhan during 1989 and 1990. It showed pneumonia (bacterial and/or verminous), starvation-mismothering exposure (SME) complex, gastrointestinal parasites, enteritis, abomasal impaction and physical injuries to be important health constraints on productivity. Neonatal mortalities were 51.5% and 46.3% on farms and on-station respectively and occurred owing to management problems such as SME, abomasal impaction and physical injuries. On the farms the lamb birth weight was 2.56 +/- 0.25 kg and was significantly (p < 0.05) affected by the dam's age, lambing weight, litter size, sex of lamb and year of lambing, but not by the season of lambing. Birth weight significantly (p < 0.05) influenced lamb mortality. Lambs with a low birth weight tended to die from SME. Morbidities and mortalities due to infectious causes increased in older lambs, suggesting that infections were acquired with age when resistance was lowered owing to inadequate nutrition and poor management. Heavy loss of lambs could be overcome by such health management interventions as foster mothering, warming lambs during the cold season and vaccination with polyvalent vaccines against pasteurellosis, clostridial infection and Dictyocaulus filaria.


[Excessive cicatrization after glaucoma-control operations: the participation of plasma fibronectin]. Based on the results of examinations of 300 patients with primary glaucoma after trabeculectomy, the author has developed clinical criteria for the evaluation of the intensity of the reparative processes at the site of intervention. Plasma fibronectin levels were found to grow with the progress of glaucoma (from Stage I to Stage II almost twofold). Analysis of correlations and regressions has revealed reliable relationships between plasma fibronectin levels and clinical values of the intensity of reparative processes at the site of surgery. Preoperative measurements of plasma fibronectin help predict with a high degree of probability the hypotensive effect of surgery.


Controlling tick infestations and diseases in sheep by pour-on formulations of synthetic pyrethroids. A field study. The use of synthetic pyrethroids in pour-on formulations reduced tick infestations and the incidence of tick-associated diseases in lambs more than dipping in organophosphate acaricides. Though the use of pyrethroids did not prevent the lambs from being infected with tick-borne fever (TBF), the incidence of lambs with lameness (tick pyaemia) or lambs suddenly found dead (Pasteurella haemolytica septicaemia), which often are seen in association with TBF, was reduced. The use of pyrethroids for three years did not seem to affect the prevalence of TBF.


Helminths of sheep and goats in desert areas of south-west Mauritania (Trarza). Faecal samples were obtained from sheep and goats before, during and after the rainy season at three locations in south-west Mauritania. Several animals were also necropsied at the same time. Haemonchus contortus was the most prevalent worm. Infection by digestive-tract strongyles and Strongyloides papillosus was always very light (prevalence less than 20%). Sheep were more heavily infected than goats but animals under 1 year of age were not infected by digestive-tract strongyles. It is likely that young small ruminants became infected during the rainy season and that the parasites so acquired are inhibited in their development and/or survive nearly one year as adults.


The effect of peri-parturient anthelmintic treatment on the productivity of dairy cattle in subtropical western India. Trials with fenbendazole (Panacur, Hoechst India Ltd) were carried out on two commercial farms in subtropical western India to study the response and economics of nematode treatment in adult dairy cows. Milk yield, lactation length, time to first oestrus and worm egg output were monitored in treated and control groups. Treatment reduced the egg count considerably. Treated cows produced 142 litres more milk over 100 days (p < 0.05), with extension of lactation length and advancement of time to first oestrus. The economic gain in terms of milk yield far outweighed the cost of anthelmintic used.


Endotoxin-induced microvascular injury in isolated and perfused pig lungs. The lungs of 13 healthy Landrace piglets were isolated, perfused and maintained in an isogravimetric state under zone III conditions. By applying vascular occlusion methods, the total blood flow resistance (Rt) was partitioned into four components: arterial (Ra), pre- (Ra') and post-capillary (Rv'), and venous (Rv). The capillary filtration coefficient (Kfc) was evaluated using a gravimetric technique. A bolus of 55 micrograms of Escherichia coli endotoxins (LPS) per 100 g of lung was injected into the arterial reservoir of eight lungs, followed by an infusion of LPS at a rate of 55 micrograms per 100 g of lung per hour for 180 min. A bolus of theophylline (85 mg per 100 g of lung weight) was injected into the arterial reservoir after the last determination of the Kfc value. All the parameters were evaluated again when the lungs reached a new steady state. Endotoxin induced a significant increase in Rt from 54.7 +/- 7.0 at zero time to 184.7 +/- 44.2 cmH2O min L-1 (100 g)-1 180 minutes later, which can be ascribed to the increase in Ra' and Rv'. These haemodynamic modifications were related to the increases in the arterial pressure and in the pressure at the distal end of the arterial segment and to the decreases in the pressure at the proximal end of the venous segment and in the blood flow. The capillary pressure and the lung weight remained unchanged. Endotoxin infusion induced an increase in the Kfc value from 0.208 +/- 0.011 (at t = 0) to 0.391 +/- 0.034 ml min-1 (cmH2O)-1 (100 g)-1 (at t = 180). Administration of theophylline significantly reduced Rt,Ra,Ra' and Rv' towards or under the baseline values and also induced a significant increase in the lung weight and in the Kfc value. It was concluded that the endotoxin-induced increase in the total blood flow resistance can be ascribed to a vasospasm occurring at the level of the pre- and post-capillary small vessels and that changes in the permeability of the endothelium greatly contribute to the development of the pulmonary oedema observed in endotoxaemic pigs.


[The effect of decimeter waves on the metabolism of the myocardium and its hormonal regulation in rabbits with experimental ischemia]. Biochemical and morphometric methods were employed to study the effect of decimetric waves (460 MHz, 10 and 120 mW/cm2) in cardiac and thyroid exposure on oxygen metabolism, myocardial microcirculation and contractility, thyroid and adrenal hormonal activity, kallikrein-kinin system activity in rabbits with experimental myocardial ischemia. Hypoxia discontinued in all the treatment regimens, but the exposure of the heart (field density 10 mW/sm2) had the additional effect on lipid peroxidation which reduced in the serum and normalized in the myocardium, on myocardial contractility, kallikrein-kinin system and on the adrenal and thyroid hormones.


[The use of sea mud in the combined therapy of patients with acute pneumonia at a hospital]. Basing on the observation on 246 patients with acute pneumonia, it is inferred that application of mud can be beneficial since the hospital treatment day 4-5. Compared to conventional, combined treatment with application of mud seems more favourable permitting more rapid attenuation of clinical symptoms and DIC syndrome, promoting active enzyme fibrinolysis and antithrombin-III, x-ray infiltration disappeared 4 days earlier, respiratory reserves and forced expiration grew.


[The optimization of the treatment of patients with chronic bronchitis at climate health resorts]. The system of staged rehabilitation of chronic bronchitis (CB) sufferers implies a sanatorium treatment stage involving climate, exercise, physical, psychological treatments, etc. In search for higher efficiency of sanatorium treatment, the analysis has been made of the response achieved in 6333 CB patients treated in sanatoria situated in various regions of the country. For all the climate conditions CB patients in remission proved the best responders. A therapeutic potential for such patients lies in better pretreatments preparation and appropriate choice of the patients in local outpatient departments, an individual approach to the diagnosis and treatment policy in sanatoria.


[The balneotherapy importance of the silicon compounds in siliciferous waters when used externally]. Bath therapy was assigned to 300 patients with primary hypothyroidism, chronic venous insufficiency of the legs, neurologic symptoms of lumbar osteochondrosis. Fresh, siliceous, siliceous carbon-dioxide and carbon-dioxide waters were tested comparatively. It is reported that siliceous baths with threshold silicon compounds concentration 50 mg/l had the effect similar to that of fresh-water baths. Indications have been specified for introduction of carbon dioxide and siliceous carbon dioxide baths in the diseases studied.


[The effect of the naphthenic hydrocarbons of naphthalane on the change in the permeability of biological membranes after ionizing radiation]. Nephthene hydrocarbons, a naphthalan active component, were tried for ability to change permeability of erythrocytic and vascular membranes for dyes. It was established that this preparation can return to normal hyperpermeability of biological membranes induced by radiation. Its mechanism of action is suggested to be participation in biosynthesis of adrenal steroid hormones and activation of some enzymatic systems.


[The action of dynamic amplipulse therapy on the urodynamics of the upper urinary tract in patients with kidney and ureteral stone fragments following extracorporeal shockwave lithotripsy]. Experimental data demonstrate that sinusoidal modulated currents are capable of increasing the frequency and amplitude of smooth muscle biopotentials in animal ureter. Basing on these findings, the authors conducted stone fragments elimination from the upper urinary tracts of patients subjected to pulse lithotripsy by means of an original physiotherapeutic complex: oral mineral water, sodium chloride baths, dynamic amplipulse therapy with 3-4 electrodes pairs applied on the renal area and different ureteral regions. The stones passage from the upper urinary tracts was reported in 91.7% of the cases. Functional improvement in the affected kidney is attributed to the stone elimination and antiinflammatory action of the above balneotherapeutic complex.


[Physical factors in the treatment of chronic enterocolitis in children]. It is a review of long-term investigations in the field of treating chronic enterocolitis in children admitted to Pyatigorsk sanatoria. The disease is proposed to be managed with different therapeutic factors: sinusoidal currents, mud, radon, oral mineral water. Such combination proved beneficial as it corrected the principal pathogenetic mechanisms of chronic enterocolitis: inflammation, dysbacteriosis, malabsorption syndrome, enzymatic defects, etc.


[The effect of cryo- and cryoelectrotherapy on regional hemodynamics in coxarthrosis patients]. Physiotherapy (cryo-, cryoelectrotherapy or sinusoidal modulated currents) and therapeutic exercise were included in the course of rehabilitation given to 110 coxitis patients. Less pronounced reduction in microcirculation in the cooled tissue was registered in the exposure to a single cryoelectrotherapy procedure than to a single cryotherapy one, activation of the blood flow that followed was more intensive. Positive trends in the local and peripheral circulation were more evident after cryo- or cryoelectrotherapy.


[The therapeutic action of the low-water bulk of therapeutic sea mud]. Clinical and laboratory investigations were carried out in 404 patients with rheumatoid arthritis and 205 with osteoarthrosis deformans, treated either with low-water curative sea mud mass, native sea mud or with combined mud and radon-bath treatment. It was found that reducing the water content of Haapsalu sea mud did not essentially influence the therapeutic effect, in consequence of which the low water curative sea mud mass may be successfully used in the treatment and rehabilitation of various patients.


[Analytical and experimental methods of determining and the significance of heat flow to the body from skin mud applications]. The paper describes mathematical and experimental methods estimating heat supply to the body from peloid applications. Rat experiments provided evidence on correlation between the energy supplied and body response in the form of alterations in heat generation and heat transfer.


[Usefulness of biochemical studies in EPH gestosis]. EPH-gestosis, especially its serious clinical complications, poses a high threat for the mother and fetus. The aetiology of this condition has not yet been completely explained. During gestosis the kidneys are most frequently involved, although other organs show changes also. The consequence of renal changes is reduction of renal blood flow and glomerular filtration rate. The studied group comprised 96 women with gestosis with at least two signs treated at the Department of Pathological Pregnancy, WAM in the years 1986-1988. The control group included 52 healthy pregnant women. Serum levels were determined of urea, creatinine-uric acid and protein. The obtained results were subjected to statistical analysis by Student's t test, accepting p less than 0.05 as statistically significant. In the group with EPH-gestosis, as compared to the control group, the uric acid level was significantly raised, while that of protein in the serum was slightly decreased. The levels of creatinine and urea were not significantly different between these groups. The raised serum uric acid level in gestosis cases was correlated with a higher frequency of instrumental labours and worse condition of the newborns at birth.


[Pregnancy, labor risk factors and neonatal mortality]. In 173 newborns dying at the Neonatology Department, Silesian Medical Academy in Katowice the risk factors connected with pregnancy and labour were analysed. The method used was analysis of onsterric cards and history of newborn development. In 67.3% of cases the newborns were born after complicated pregnancy and 39.9% after complicated labour.


[Pregnancy and labor in multiparae].

[Pregnancy and labor in multiparae]. The course of pregnancy, labour and puerperium was analysed in 53 women in labour for the fifth time or more. It was found that many multiparae came from the lowest socioeconomic class and only rarely visited maternity clinics, as compared to the control group of 96 primigravidae and primiparae. They had more frequently earlier termination of pregnancy, premature rupture of membranes, and after labour incomplete placental expulsion and urinary tract infections were more frequent in them. The newborns in this group were more often stillborn or had low Apgar score.


[Psychological aspects of the treatment of children with terminal renal failure by repeated hemodialysis]. Adaptation difficulties of adolescents during treatment with repeated dialyses are discussed. Emotional status was studied in 5 such cases. In all of them long-standing mood depression was found. The necessity of systematic psychotherapeutic care in such cases is stressed.


[The role of antiglobulin antibodies in pathophysiology of various internal diseases]. Antiglobulins are a heterogenous group of antibodies specific for a large number of antigenic determinants on the heavy chains of various classes and on light chains. They are capable of reacting with hidden antigenic determinants of gamma globulins after they have been exposed by the action of proteolytic enzymes or after antigen-antibody reaction during which changes occur in the spatial configuration of the Fc fragments of immunoglobulin causing that they assume immunogenic properties. Antiglobulin antibodies against episomes in the Pab fragment of other antibodies have a strong regulatory influence on the immune response in view of their ability of specific interference with the response to a specific antigen. Antiglobulin antibodies may exert a protective effect but also a pathogenic effect. The latter has been demonstrated in atopic diseases, in IgA glomerulonephritis, in rheumatoid arthritis, in infectious mononucleosis, cryoglobulinaemia, in patients with IgA deficiency associated with presence of antiglobulin antibodies to IgA after transfusion of plasma or intravenous infusion of gamma globulins containing IgA.


[Secondary polycythemia as an example of the paraneoplastic syndromes]. The modern views on the coexistence of secondary polycythaemia with benign and malignant tumours of varying origin are reviewed describing certain mechanisms determining this association. The diagnostic management of secondary polycythaemia is outlined calling attention to the necessity of ruling out coexistence of a neoplasm.


[Nephrotoxic effect of gentamicin on the function of the proximal tubules of the nephron and glomerular filtration]. The purpose of the study was assessment of gentamicin nephrotoxicity with reference to proximal tubule function and glomerular filtration. The study was carried out in 20 patients with nephrolithiasis and chronic pyelonephritis, and 33 patients with respiratory and bile tract infections treated with gentamicin in doses of 2-3 mg/kg/2 h. In 3 patients with nephrolithiasis and chronic pyelonephritis signs of increased nephrotoxicity of gentamicin (according to Schentag criteria) were found. Similar signs were demonstrated in 3 patients with non-urinary tract infections. The abnormalities included increased excretion of low-molecular protein and beta-2-microglobulin (B2m), reduction of B2m reabsorption and lower glomerular filtration. Beta-2-microglobulinuria increase precede by 4-5 days the fall of the glomerular filtration rate which suggests that beta-2-microglobulinuria assessment is an early sign of gentamicin neurotoxicity.


[Hemolytic anemia caused by excessive use of analgesics]. A 40-year-old female patient is reported who gave a history of analgesics abuse (phenacetin) and had haemolytic anaemia. The probable mechanism of the toxic effect of phenacetin on the haemopoietic system through induction of intravascular haemolysis (so called stibophen-type haemolysis) is discussed. One-year follow-up demonstrated the reversibility of these haematological changes.


[Ultrasonographic image of small-intestinal lymphoma]. A case of small intestine malignant lymphoma was observed in a man aged 56 years. The only imaging method which demonstrated the presence of abdominal tumour was ultrasonography. The features of the USG image are discussed for facilitating the diagnosis of this rare tumour.


[Subcutaneous emphysema of the anterior chest wall as the only symptom of spontaneous rupture of the esophagus]. A diagnostically difficult case of Boerhaave's syndrome is reported. The patient gave a history of subcutaneous emphysema of the anterior chest wall as the only sign. Aspiration drainage through thoracotomy opening and artificial alimentation through jejunostomy were used with success.


[A rare case of coexistence of aneurysm of the abdominal aorta and sigmoid neoplasm]. A rare case is reported of coexistence of aortic abdominal aneurysm with sigmoid tumour. Emergency surgical treatment was instituted.


[TAR syndrome (congenital thrombocytopenia and aplasia of the radial bones) in a 5-months-old boy]. A boy aged 5 months had the TAR syndrome (thrombocytopenia and aplasia of radial bones) of autosomal recessive inheritance. Bilateral reduction of the length of the upper extremities included both forearm bones and humerus, so that the shoulder girdle was connected directly to the hand, with all fingers and thumb normally shaped. These skeletal anomalies were associated with thrombocytopenia. Various other abnormalities were present, with the most controversial anomaly being bilateral cleft of the lip and secondary palate. It may be an accidental coexistence of abnormalities or may suggest a common mechanism of the development of the TAR syndrome, Roberts syndrome and SC-phocomelia belonging to hereditary reduction of the extremities with identical mode of inheritance.


[Clinical course of symptomatic toxocariasis in a 10-year-old boy]. A case is described of symptomatic toxocariasis in a boy, with massive invasion of the parasites and strong response of the organism. The course of the disease was very serious.


[Mechanical obstruction of the small intestine]. A group of 193 patients treated for mechanical occlusion of the small intestine in the years 1978-1987 at the hospital in Jasło were analysed. The epidemiological index of this occlusion was 14.8 per 100 thousand of the population annually, the total mortality was 11.4%. The risk was greatest in patients with incarcerated hernia operated on with delay, especially in old age, in whom intestinal resection had to be done. In cases with necessary intestinal resection in the vicinity of the ileocaecal valve the results were better if the valve was resected with adjacent part of the intestine and ileostomy and colostomy was done.


[Biochemical markers of bone remodelling and their usefulness in the diagnosis of osteoporosis]. In 65 subjects (42 women and 23 men) aged from 40 to 80 years, at risk for primary or secondary osteoporosis development without concomitant diseases affecting renal and hepatic function and vitamin D metabolism, alkaline phosphatase activity (F.A.s) and total calcium level (Cas) were determined in the blood serum, and also the excretion in the morning urine portion of hydroxyproline and calcium was measured in relation to creatinine excretion (FUHpr/kr; FUCa/kr). In each patient an X-ray was done of the thoracolumbar spine, and on its basis the X-ray vertebral index was calculated. The study has been undertaken in order to elucidate whether the above stated compounds regarded as biochemical markers of bone remodelling, and the X-ray vertebral index are useful in the diagnosis of osteoporosis. An increased F.A.s activity in the blood serum, and higher values of the X-ray vertebral index were found both in the group of patients with primary and secondary osteoporosis, in relation to normal values. It was found that FUHpr/kr and FUCa/kr were increased in patients with secondary osteoporosis in comparison to patients with primary osteoporosis. A statistically significant correlation was also noted between FUHpr/kr and FUCa/kr, and F.A.s in patients with primary and secondary osteoporosis. In both studied groups no relationship was found between the value of the X-ray vertebral index, and the levels of biochemical markers of bone remodelling.


[Evaluation of the effectiveness of medical prophylactic procedures applied to workers in ports]. The purpose of the study is an evaluation of the effectiveness of the introduced medical prophylactic procedures among workers employed in zone of pollution with inorganic dusts. Medical and laryngological examinations were done several times in 125 workers of the Maritime Merchant Haven in Gdańsk overloading phosphates, apatites, and crystalline sulphur compounds. In all studied patients systematic procedures were applied of rinsing the nasal and oral cavities with normal saline. A protective gel and also mucolytic drugs, among others Mistabron, were applied intranasally. Toxicological examinations were done of the nasal cavity washings with measurement of the quantity of phosphorus in cm3 before and after rinsing. The phosphorus concentration before the hydrotherapy procedure was X = 12.7 Ug/cm3, and X = 0.65 Ug/cm3 after the procedure. After using of prophylactic measures for two years, a reduction was achieved of the number of workers with respiratory tract diseases by 60% in the Sulphur Overloading Division, and by 34.2% in the Raw Phosphate Fertilizers Overloading Division.


[Factors of the "acute phase" in proliferative diseases of the hemopoietic system]. In proliferative diseases of the homeopathic system before starting and at the end of treatment, the values of 8 acute phase factors were studied simultaneously, that is: seromucoid, sialic acid, alpha 1 acid glycoprotein, alpha 1 antitrypsin, haptoglobin, ceruloplasmin, transferrin, and fibrinogen. In chronic myeloid and lymphatic leukaemia no constant increase nor decrease of the concentration of any of the factors was found. In non-Hodgkin lymphoma the concentration of one factor -ceruloplasmin was constantly increased, and that of two factors--sialic acid and fibrinogen was decreased, while in plasmocytoma the concentration of two factors--haptoglobin and ceruloplasmin was constantly increased. At the end of treatment the concentration of certain factors was changing. In chronic myeloid leukaemia the concentration of ceruloplasmin, fibrinogen, and seromucoid was decreasing, while in non-Hodgkin lymphoma the concentration of haptoglobin and fibrinogen was increasing, in chronic lymphatic leukaemia the concentration of haptoglobin and increasing, in chronic lymphatic leukaemia the concentration of haptoglobin and transferrin was increasing, and in plasmocytoma the concentration was increasing of haptoglobin, sialic acid, and transferrin. The result of treatment in chronic myeloid leukaemia was good, in non-Hodgkin lymphoma and chronic lymphatic leukaemia--moderate, and in plasmocytoma it was least beneficial.


[Thoracic sympathectomy in the treatment of chronic ischemia of upper extremities and excessive sweating of the palms]. The results are presented of treatment of 65 patients with chronic peripheral ischaemia of upper extremities and excessive sweating of the palms, in whom 78 thoracic sympathectomies were done by the Smitwick method in the years 1972-1989. The cause of ischaemia in 45 patients were organic changes (TO, AO), in 18 cases--functional changes (Raynaud syndrome), and in two patients--excessive sweating of the palms. Patients with trophic changes were 72% of those surgically treated. Long-term follow-up (8.5 years on the average) demonstrated a significant improvement in the group of organic changes in 84% of the surgically treated cases, in the group of functional changes in 83.2% of cases, and in excessive sweating of the palms in 100% of cases. In five patients contralateral effect of thoracic sympathectomy was observed. The authors discussed the extent of sympathetic trunk removal. They think that thoracic sympathectomy is a procedure of choice in cases of peripheral ischaemic changes in upper extremities not responding to conservative treatment.


[Appearance of antibodies against hepatitis type A virus (HAV) in alcoholics]. In 144 alcoholics--patients of alcoholic outpatient clinic anti-HAV antibodies were studied using the commercially available ELISA test. Anti-HCV antibodies were found in 86% of the alcoholics, and this prevalence was not higher than in the control group. No differences were found in the titre of antibodies against cytomegaly and herpes virus between the subjects with and without anti-HAV antibodies which suggests the specificity f the determined anti-HAV antibodies.


[Chronic active hepatitis in alcohol abusers]. 12 cases of chronic active hepatitis in chronic alcohol abusers are described. All patients were HBsAg negative and 7 were anti-HCV positive. Four out of 5 anti-HCV patients quickly progressed to liver decompensation. It seems that chronic hepatitis seen in chronic alcohol abusers can be divided into two groups: one due to HCV infection and the other due to sensitivity to alcohol, respectively.


[Cell-mediated and humoral immunity in children with down syndrome]. Forty-three children were studied, aged 3 months to 10 years, with Down syndrome confirmed by karyotype studies. A statistically significantly decreased percent was found in them of "E" rosette-forming T lymphocytes. The percent of "EAC" rosette-forming B lymphocytes was normal. The concentration of IgG, IgA, and IgM immunoglobulins was about normal for age.


[Concentration of serum proteins in children with down syndrome]. In the serum of 41 children with trisomy 21 (Down syndrome) the concentration was determined of 10 proteins by the radial immunodiffusion method. It was found that the concentration of prealbumin and alpha 2-macroglobulin was lower than in healthy children. The concentration of acid alpha 1-glycoprotein, alpha 1-antitrypsin, haptoglobin, C4 complement component, and hemopexin was higher than in healthy children. The concentration of ceruloplasmin, C3 complement component, and transferrin was similar as in healthy children.


[Familiarity with diseases of the esophagus, stomach and pancreas among trainees who applied for specialization in general surgery]. The range of knowledge of the diseases of oesophagus, stomach and pancreas amongst 277 trainees in general surgery has been investigated by means of the 180 multiple-choice question examination. Analysis of the results revealed that the knowledge of the above subject with constituted 19% of the questions, does not differ from that of the rest of general surgery problems, distributed in the remaining 81% of the test's content.


[Effect of oestro-feminal on lipid metabolism in postmenopausal women]. The cessation of hormonal function of ovaries after menopause leads, among others, to changes of concentration of serum lipids and lipoproteins which may cause an increased risk for atherosclerosis. The purpose of the study was an evaluation of the effect of three- and six-month use of conjugated oestrogens on lipid metabolism in women after surgically induced menopause. Both after three and six months of treatment a reduction of intensity or abolition was found of the climacteric syndrome symptoms. After six months of substitutive therapy beneficial changes were observed in lipid metabolism (decrease of total and LDL-cholesterol levels, and increase of HDL-cholesterol level). Hormonal therapy may play a protective role and prevent the development of atherosclerosis in women after menopause.


[Evaluation of remote results in 80 intra-articular calcaneal fractures treated by various methods]. The studies were done in 69 patients in whom 80 intra-articular calcaneus fractures were diagnosed of tongue or crush type. In the analysis of the remote results a subjective three-grade evaluation of the results was used as reported by the patients. The good results in 60% were closely related to the reconstruction of the shape of the calcaneus and its articular surface with simultaneous restoration of functional fitness of the foot. It was found that the fractures of tongue type were to be reduced by the Westhues method, while the crush fractures were to be treated surgically or functionally. Poor results were observed in all fractures not reduced and not immobilised additionally in plaster casts.


[The heart in arterial hypertension].

[The heart in arterial hypertension]. The data is presented on the pathogenesis of myocardial changes in arterial hypertension. The non-haemodynamic causes are discussed of myocardial hypertrophy, as well as the participation of collagen in its early phase and the haemodynamic consequences of hypertrophy and its regression. Hypotensive drugs and their ability ot prevent myocardial hypertrophy and (or) inducing of its regression were compared.


[Sex hormone-binding globulin (SHBG) under physiological and pathological conditions]. The concentration of sex hormone-binding globulin (SHBG) in blood depends on the sex, age, metabolic status of the organism, liver function, and gonad function. The circadian rhythm of somatotropin secretion is an important regulator of SHBG synthesis and secretion, and its passage from vascular bed to the tissues depends on somatomedin-C. The concentration of SHBG in the serum is thus the resultant of the synthesis of this glycoprotein in the liver and the ability of its uptake in the cells of target tissues for sex hormones.


[A case of endocardial elastosis in a 5-week old infant]. A case is presented of fulminant endocardial elastosis in a 5-week-old infant. The baby died after four days from the appearance of the first pathological symptoms with evidence of extreme circulatory insufficiency. Of main importance for intravital diagnosis was echocardiographic examination. The autopsy confirmed the diagnosis. The myocardium was hypertrophic without evidence of inflammation. The typical changes for this disease were found in parietal endocardium of both ventricles, both atria, as well as both atrioventricular valves, and aortic valve.


The effects of aerobic exercise on psychological adjustment: a randomized study of sedentary obese women attempting weight loss. This study evaluated the psychological effects of aerobic conditioning in 40 moderately obese, sedentary women participating in a 12-week behavioral weight loss program. Participants were randomly assigned to a no-exercise or moderate walking condition. Emotional impact of the treatment was assessed in two ways: (1) Subjects reported subjective mood prior to each eating episode and (2) the SCL-90-R was administered before and after the program. Exercisers lost more weight and body fat than non-exercisers. Both groups of subjects showed numerous improvements in mood as a result of participating in the weight loss program. Exercise had no specific differential effect on emotions as measured by daily mood ratings or the SCL-90-R. Exercise did not appear to add appreciably to the psychological benefits of losing weight in this sedentary obese population. Future studies utilizing longer periods of aerobic exercise training, larger sample size, and exercise specific measures are recommended.


Women's social roles and their exercise participation. How women's social roles such as parenthood, marital status and employment status affect their exercise participation, is important for the rational planning of suitable and effective exercise programs for women in different social contexts. A secondary analysis of a large data-base of urban women aged 20-49 (n = 5939) was carried out to determine if social roles, their characteristics and their combinations were related to women's exercise participation. Parenthood and marital status were significantly related to whether women exercise, and among those exercising, all three roles were significantly related to the amount of exercise. Statistical modelling, including all three roles and their interactions, controlling for age and education, showed that with respect to whether women exercise, parenthood affected exercise participation most and that its effect was dependent on age. Of the role characteristics only the number of children and overall satisfaction with daily activities improved the prediction of exercising. With respect to how much women exercise, the effect of parenthood interacted with marital status. Married parents were least likely to exercise very much. Of the role characteristics only overall satisfaction with daily activities improved the prediction of the amount of exercise.


Diet and activity patterns of male and female co-workers: should worksite health promotion programs assume homogeneity? Worksite health promotion programs address the health education needs of the average employee. Anthropometric measurements and 24h diet and activity diaries collected from co-workers reveal that lifestyle and subsequently, health education needs of men and women working for the same employer, in the same environment and performing similar tasks, may be different. In this study, males were marginally overweight and obese; females were within recommended limits. Although job related workloads were comparable, females were more active (24hEE/FFM) outside the work place. Females spent more time engaged in moderate weight-bearing domestic activities than did males. These results question the effectiveness of worksite health promotion program which ignore the different health education needs of male and female employees.


Drinking behaviors of women in four occupational groups. Questions about alcohol consumption, social and work contexts, and negative consequences related to alcohol use were asked of forty-nine academics, 27 physicians, 15 attorneys, and 169 business women. The majority of the women were light drinkers and their drinking does not appear to be accompanied by negative consequences. The exception to this is driving while intoxicated or riding with an intoxicated driver, behaviors which may be increasing as a result of business-related or after work drinking. The women reported being in drinking settings relatively often. Frequency in drinking settings was correlated with both level of alcohol consumption and number of negative consequences of alcohol use. Presence in such settings may be related to women's employment status, and thus could be considered both a work-related risk factor and a location for abuse prevention activities.


Gender and race: an interaction affecting the replicability of well-being across groups. The Life Satisfaction Index (LSI) continues to be one of the most frequently used measures of well-being in social gerontology. Discrepancies in the operational use of the LSI, however, have made comparisons across studies difficult. Few studies have incorporated examination of the effect of gender/race interactions on the performance of the LSI. The purpose of this study was to examine differences in the hierarchical factor structure of life satisfaction among four gender/race groups using previously reported item pools and coding schemes. Three second-order, three-factor life satisfaction models were examined using confirmatory factor analysis techniques with four groups of older adults: White men (n = 846), White women (n = 1341), Black men (n = 177), and Black women (n = 287). In general, results showed differences in LSI factor structure across gender/race groups. With regard to coding scheme, models using Neugarten et al.'s original coding scheme (1961) and those using Wood et al.'s alternative scoring (1969) were similar. Examination of models using different LSI item pools showed that the factor structure of life satisfaction was affected by the gender/race interaction, underscoring the problem of misspecification resulting from the sum of LSI items and use of the summated score as a unidimensional measure of well-being. Implications for future research are discussed.


[A study of perspective vision].

[A study of perspective vision]. The present study describes the structure of monocular depth perception using an experimental basis. It regards the traditional theory of perspective, which is a subset of descriptive geometry, only as a construction guide for flat, albeit depth eliciting, visual stimuli. The investigation starts with a definition of structure as a set with an automorphism on it. In the present context the projection of the physical stimuli onto the retina provide a suitable ground set. After suitable confinement of the stimuli to a horizontal plane, the effects of eye and head movements of the subject can be represented as projective mappings of the retinal image onto itself. The present approach represents these as visual automorphisms. They are each characterized by a special visual invariance. The automorphisms form a group which comprises the affine, the affine unimodular and the orthogonal groups (in this order) as subgroups. Experimental studies of the different invariants of these subgroups as well as the consideration of other empirical observations lead to the conclusion that the structure of monocular space perception is characterized by the affine unimodular subgroup of the projective group. There are indications that the phenomena of size constancy can be represented by affine unimodular maps instead of orthogonal (metric) maps as sometimes has been conjectured.


[Experimental induction of emotional conditions--alternatives to the Velten method]. The technique most often used to induce emotion is based on self-referent statements read by the subjects (Velten, 1968). This technique is known to be of intermediate efficiency. Therefore film and hypnosis-like procedures were investigated as alternative techniques. Efficiency was tested using two selected scales of a mood questionnaire (SES by Hampel, 1977). The subjects were male and female students. Both alternative procedures allowed us to induce significant changes in Ss' moods. The film method was more efficient than the Velten-technique in inducing a negative mood, whereas it was equally efficient in inducing a positive mood. The hypnosis-like procedure, however, was not more efficient than the Velten-technique. Obviously film is a quite efficient and easy applicable alternative technique to induce moods.


[Dependence of 'audio-phonatoric coupling' of speech rate and speech loudness]. The 'audio-phonatoric coupling' (APC) was investigated in two independent experiments. Slightly delayed auditory feedback (delay time 40 ms) of the subjects' own speech was used as experimental method. The first experiment was conducted to examine whether the strength of the APC depends on the speech rate. In this experiment 16 male Subjects (Ss) were required to utter the testword/tatatas/either with stress placing on the first or second syllable at two different speech rates (fast and slow). In 16% of the randomly chosen speech trials, the delayed auditory feedback (DAF; 40 ms delay) was introduced. It could be shown that the stressed phonation was significantly lengthened under the DAF condition. This lengthening was greater when Ss spoke slowly. The unstressed phonations were not influenced by the DAF condition. The second experiment was conducted to examine whether or not speech intensity effects APC. Nine male Ss were required to utter the testword/tatatas/either with stress placing on the first or second syllable using three different speech intensities (30 dB, 50 dB and 70 dB). In 16% of the randomly chosen speech trials DAF condition was introduced. It could be shown that speech intensity does not influence the DAF effect (lengthening of stressed phonation). These findings were taken as evidence that the auditory feedback of the subjects' own speech can be incorporated into speech control during ongoing speech. Obviously, this feedback information is efficient only during the production of stressed syllables, and varies as a function of speech rate. In addition, the significance of stressed syllables for the structuring of speech is discussed.


[Judgment of the credibility of rape allegations: a content analytic field experiment]. This study explores the issue of whether allegations of rape can be correctly identified as true or false on the basis of a set of content criteria used successfully in previous studies with respect to children's accounts of sexual abuse. A sample of 30 authentic protocols of police interrogations of women reporting rape were selected for the study. Fifteen cases were classified as false accounts because the complaints eventually confessed to having fabricated their allegations. The remaining cases were classified as true rapes on the basis of medical and other corroborating evidence. A group of experienced police officers (N = 30) judged these cases in terms of their credibility on the basis of the 19 content criteria suggested by Steller & Köhnken (1989) and gave an overall judgment of the true vs. false nature of each statement. A second group of police officers (N = 22) judged the credibility of the statements without reference to these criteria. The findings from a series of discriminant function analyses showed that the set of criteria as a whole is successful in distinguishing between true and false rape allegations. The results of the stepwise discriminant function analyses reveal which criteria in particular contribute to the correct identification of true and false cases. However, the higher percentage of correct classifications in the group using the content criteria was only marginally significant compared to the second group judging the cases without reference to the criteria. Altogether, the findings of this study support the basic tenet of statement analysis that the linguistic features of a statement contain essential clues for assessing its credibility.


[Reaction time and temporal serial judgment: corroboration or dissociation?]. Dissociations between a motor response and the subject's verbal report have been reported from various experiments that investigated special experimental effects (e.g., metacontrast or induced motion). To examine whether similar dissociations can also be observed under standard experimental conditions, we compared reaction times (RT) and temporal order judgments (TOJ) to visual and auditory stimuli of three intensity levels. Data were collected from six subjects, each of which served for nine sessions. The results showed a strong, highly significant modality dissociation: While RTs to auditory stimuli were shorter than RTs to visual stimuli, the TOJ data indicated longer processing times for auditory than for visual stimuli. This pattern was found over the whole range of intensities investigated. Light intensity had similar effects on RT and TOJ, while there was a marginally significant tendency of tone intensity to affect RT more strongly than TOJ. It is concluded that modality dissociation is an example of "direct parameter specification", where the pathway from stimulus to response in the simple RT experiment is (at least partially) separate from the pathway that leads to a conscious, reportable representation. Two variants of this notion and alternatives to it are discussed.


[Evaluation algorithm for eye movement patterns during a problem solving task]. Cognitive processes are accompanied by eye movements, which are interrupted by fixations of an almost infinite number of points in the visual field. To investigate these processes, a systematic analysis of those movements is required to structure the long sequences of fixations. This task is possible if there are interrelationships between the ongoing thought processes and the fixations. Such interrelationships may manifest themselves through certain patterns of eye movements. It often happens that subsets of visual points are being looked at repeatedly. This is because a cognitive connection among the subset's elements is being discovered or created by such repetition. The method presented here attempts to achieve automatic recognition of fixation point patterns. Its usefulness is demonstrated using data from an experiment where eye movements were recorded while subjects were solving Raven Test items. The method may be characterized as a variant of time series analysis for nominal data. It is suitable for non-numerical data in general.


[The tail suspension test: its theory and practical application]. The tail suspension test (TST) was originally proposed by Steru et al (1985) as a primary screening test of anti-depressant drugs. In this test, it is shown that tail suspension-induced immobility of mice is specifically antagonized by such drugs. More recently, the automated version of TST (ITEMATIC-TST) was developed by the same authors. In the present paper, we described our own device which utilized spring, contactless micro angle potentiometer, A/D converter and personal computer. Results obtained with this apparatus showed that repeated, not single, administration of tricyclic and atypical antidepressants could reverse the immobility of mice. Methamphetamine also activated the behavior, but other psychotropic drugs did not have positive results. Based on these findings, the usefulness and problems of our device were discussed as compared with the original TST.


Correction of the luteal phase defect with clomiphene citrate. Among the various strategies proposed for the therapy of the luteal phase defects (L.P.D.), the administration of clomiphene citrate during the early follicular phase has proved to be very effective even though it is not one of the most used. Nevertheless, very soon has been risen the question if such drug acts by an overphysiological increase of the hormonal levels or instead by a re-balance of the altered latter ones. In order to answer this question a clinical study was carried out during 265 cycles on 63 normally ovulating and menstruating women, whose 27 with a luteal phase defect (L.P.D.), detected by clinical, echographic, endocrine, and morphological criteria. Each of these latter patients were given clomiphene citrate, 100 mg per day from the 2nd to the 6th day of the cycle, for a total of 108 cycles. The other 36 women without any luteal abnormality, were used during 156 cycles, as a control group. At the end of our study there were no significant differences in all parameters between two studied groups. This suggest that early follicular phase administration of clomiphene citrate in these pathologies can act by gradually improving the luteal function.


CA-125 and ovarian hyperstimulation.

CA-125 and ovarian hyperstimulation. The ovarian hyperstimulation syndrome (OHSS) has become more and more frequent in relation to the spread of the method of superovulation by means of pharmacologic induction and consequently the necessity of measures suitable for preventing and controlling it has been more and more improved. Among them the discovery of indicators which could reveal as early and sensitive as possible the onset and, when it is possible, also the degree of severity of this syndrome, holds an important position. Till now only the serum estradiol concentration performed this task, among the other things, in an incomplete and not-well defined manner, but its inadequacy has stimulated once again the search for new substances which would allow attention to be drawn to the development, entity and evolution of this syndrome in compliance with necessary requisites with greater timeliness, and tenacity. Therefore the behaviour of the serum CA-125 levels has been evaluated for the first time in 31 cycles of 31 patients, which were stimulated by gonadotropins (FSH, FSH/LH, HCG), of which 21 underwent ovarian hyperstimulation of various degree (10 of I, 8 of II and 3 of III grade), while the other 10 had no complications. The blood levels of this marker rose above the limit considered physiological (35 UI/ml) during the luteal phase in all the stimulated cycles and, in hyperstimulated ones always exceeded 70 UI/ml; in addition the serum CA-125 levels correlated very well with ovarian dimensions, degree of severity of the syndrome and estrogenic concentrations during only luteal phase, in the hyperstimulated cycles and continued to remain high or even increased in case of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)


Gynecologic interventional radiology.

Gynecologic interventional radiology. Interventional radiology now finds a wide range of applications in the gynecologic area. They can be divided in general procedures applied to gynecology and procedures specific to gynecology.


[Experimental pancreas transplantation]. Experimental pancreatic transplantation was performed in dogs using different surgical techniques. Ten dogs underwent whole organ graft with diversion of exocrine secretion by anastomosis of duodenal segment to bladder (six animals) and of duodenum to a jejunal loop (four animals). Segmental pancreatic grafts were performed in 10 dogs with ductal filling with polymer in six animals and duct ligation in four dogs. It is concluded that segmental pancreatic graft with ductal filling with polymer is preferable to the other surgical techniques.


Indomethacin and fertility in experimental endometriosis. Clinical and experimental evidence showed an increased concentration of prostaglandins in peritoneal fluid in cases of endometriosis. The aim of this study was to verify whether an antiprostaglandin drug can restore fertility in cases of endometriosis. For this reason endometriosis was induced in 4 groups of 10 rats. Group A was treated with indomethacin both in the pre-ovulatory and in the post-ovulatory phase. Group B was treated in the pre-ovulatory phase. Group C was treated in the post-ovulatory phase. Group D was not treated. Ten other rats (group E) underwent a sham operation and were used as a control. Twelve days after mating, gestational sacs and corpora lutea were counted and the nidation index was calculated. Only indomethacin administered during the pre-ovulatory phase completely restored fertility in these rats.


[Incidence of cholelithiasis in patients with cancer of the colon and adenomatous polyp]. Recent international publications remark the association about carcinoma of the colon and cholelithiasis. These two entities with similar geographical distribution can be seen frequently in the modern western societies, being the cause as aetiological factors the low content in dietetics fiber. Different studies about the carcinoma of the colon and cholelithiasis pathogenesis had lead the possibility that the abnormal degradation of bile acids for the colonic bacterias, could be responsible of each one of these illness. The exposition of colonic mucosa to products of degradation of bile acids, specially secondary bile acids, may play a role in the etiopathogenic of colon carcinoma. It was analysed 135 patients with colon carcinoma or adenomatosis polyps, 42 with cholelithiasis or cholecystectomized for the same cause (31.1%), although in the control group, only 2(5%) had cholelithiasis. The female predominated the group of colon carcinoma and cholelithiasis, as well as cholecystectomized for that cause. The most frequent associated pathology was the diverticulosis.


Effect of human gamma interferon on mice testis: a quantitative analysis of the spermatogenic cells. Effect of Human Gamma Interferon (Hu-IFN-gamma) on the testicular histology was studied in mice. Male mice were administered Hu-IFN-gamma intratesticularly at the doses of 2, 10 and 20 micrograms/testis in a volume of 1.0 microliter isotonic normal saline. Contralateral testis served as control and was administered same amount of vehicle. All the animals were sacrificed 7 days after drug administration. Body weight and the weights of testis and epididymis were not affected by IFN treatment nor was there any effect of the drug on the motility of the vas deferens spermatozoa. Low dose of IFN (2 micrograms) did not have significant effect on the histoarchitecture of the testis and various spermatogenic elements, a progressive damage was however observed with the increasing doses of IFN. Pronounced deleterious effect of IFN on the testis leading to desquamation of the germinal epithelium, reduction in the germinal cell height and tubular diameter was observed with 20 micrograms dose. Quantitative studies on seminiferous epithelium showed a significant decrease in the number of Sertoli cells, stage-7 spermatids and stage-16 spermatozoa. The ratios of resting type spermatocyte: type A spermatogonia and stage-7 spermatids: pachytene spermatocyte was also reduced. The ratios of pachytene spermatocyte: resting spermatocyte and stage-16 spermatozoa: stage-7 spermatids were however not affected by IFN treatment. In another experiment IFN was administered (2 micrograms/day) subcutaneously to male mice for 30 days. No effect of drug treatment on body weight, organ weight, sperm motility and histology (including morphometry) of the testis was observed. Our data suggest that IFN action at testis may be associated with the antiproliferative effect of interferon.


[Professional risk: hepatitis B. Vaccination strategies in a general hospital]. The risk of contracting hepatitis B: (HBV) by health workers is widely accepted. In 1989 our Hepatology Service started a voluntary anti-HBV vaccination program, employing recombinant vaccine (SKF) by intramuscular route with a 0-1-6 month schedule after screening with antibody against the anti-core HBV antigen (AntiHBc Elisa Abbott). Initially, it was planned to monitor antibody titers against superficial antigen (Anti-HBs) 30 days after the last dose. An epidemiological form listing personal data, working area, profession, seniority, written consent for blood extraction and tentative acceptance of vaccination, was completed by 357 hospital staff members. After serological screening, only 184 (51%) workers agreed to receive vaccination. Given the paucity of volunteers, an attempt was made to explain this degree of reluctance by a randomized blind voluntary survey, to which 349 hospital staff members and 40 medical students replied. Questions were related to knowledge concerning vaccination in general, hepatitis and particularly hepatitis B, and specific anti-HBV vaccination. An appraisal of data gathered disclosed a considerable lack of information not only on the risk of HBV infection and its complications, but also on the existence of a suitable vaccine. Non-existent adverse effects of vaccination were mentioned, including AIDS (Acquired Immuno-Deficiency Syndrome), hepatitis and cirrhosis, among others. To overcome this obstacle, we held a two-day workshop on hepatitis B prevention and prophylaxis intended for medical and ancillary staff. After the meeting, which were attended by 221 members, 48 individuals, comprising 25 physicians and 23 nurses, spontaneously requested to be vaccinated.(ABSTRACT TRUNCATED AT 250 WORDS)


[Manometric effects of pinaverium bromide in irritable bowel syndrome]. The effects of pinaverium bromide on colonic motility were investigated in a controlled, controlled, cross-over study in 32 patients with irritable bowel syndrome. Constipation was clearly predominant in one group of 16 patients, and diarrhea in the other group of 16. Manometric measurements were taken of the colonic motor response generated by distention of a balloon inserted to the rectosigmoid junction. Measurements were taken before and one hour after ingestion of two tablets containing placebo or two tablets each containing 50 mg of pinaverium bromide. Following intake of placebo the motility index increased from the basal value in patients with constipation, and resistance to distention decreased in the diarrhea group. These changes were attributable to repetition of the mechanical stimulus within a relatively brief time lapse, or more probably to the ingestion of liquid which accompanied intake of tablets. Compared with placebo, pinaverium bromide induced inhibition of both effects. From the therapeutic point of view, the decrease in motility index seen in patients with irritable bowel syndrome and constipation is particularly interesting.


[Intestinal duplication. Report of 2 cases]. Intestinal duplications are rare and they result from embryological failures in the canalization of the gastrointestinal tract. This paper presents a case of ileal intestinal duplication and its differential diagnosis from Meckel's diverticulum. Besides, a case of rectal duplication in an asymptomatic elder patient is presented.


[Benzodiazepine metabolism in experimental extrahepatic cholestasis]. The aim of the present study was to determine the effect of bile flow impairment on hepatic lorazepam detoxication and its relationship with the liver microsomal membrane phospholipid composition. It was observed a decrease of phosphatidylcholine, phosphatidylinositol, phosphatidylethanolamine and sphingomyelin content and an increase of phosphatidylserine and phosphatidylglycerol. A similar activity on lorazepam detoxication was observed when cholestatic rats were compared to controls. These results suggest that there is a different modulation than the phospholipid environment play the key role in lorazepam metabolism, independently of membrane.


Gastroparesis: medical or surgical therapy? It is presented the case of a 63-year-old female patient, who was admitted to the hospital for the first time, because of clinical picture compatible with acute cholecystitis and choledocholithiasis. She underwent cholecystectomy common bile duct (cbd) exploration, and duodenotomy, with the extraction of two stones located in the distal cbd. During her postoperative course, she had been under a great emotional tension, and ten days after her surgical intervention, she developed symptoms and signs of acute gastric dilatation, requiring a second admission. A barium meal and an upper endoscopy revealed gastric dilation, with marked pyloric spasm. Her complaints improved after conservative therapy was instituted. No surgical intervention was necessary. We concluded that the cause of her gastric retention was due to the emotional stress present during her postoperative course, which produced marked pyloric spasm, and not from an organic cause.


[Diagnostic value of abdominal pain in intra-abdominal desmoid tumor]. Desmoid tumors are rare, less than 0.1% of all tumors (6.2%). The word desmoid has been recognized since 1838, and applied to non-encapsulated tumors, of connective origin and locally infiltrative. Generally, their course is painless and the recurrence rate is high if resection has not been complete. Most of these tumors can be found in different anatomic areas, most commonly the anterior abdominal wall although other sites, intra- or extra-abdominal, have been reported. We describe the case of a 50 year old female patient, with abdominal pain caused by an intraabdominal desmoid tumor.


[Chemical composition of gallstones in Santa Cruz--Bolivia]. The knowledge of the gallstones chemical composition is very important from view point of lithogenesis and possible medical therapy of dissolution. The composition (chemical) of gallstones in 30 consecutive cholecystectomized patients were studied in the 2nd. Department of Surgery of Hospital San Juan de Dios, Santa Cruz, Bolivia (altitude 1900 m). All gallbladder stones were washed, counted, measured and dried before sending them to Japan to be processed. The composition of gallstones was analyzed by infrared absorption spectroscopy. Cholesterolemia, age, sex and number of stones were analyzed in cases of pure cholesterol stones. The incidence of pure cholesterol stones was 56.6%, statistically similar to be reported by other authors, but very low if compared with the valley area of Bolivia (Cochabamba altitude 2300 m) where hypothyroidism is frequent. Hypercholesterolemia had little relation with the pure cholesterol gallstones. There was no difference in the chemical composition and the size of the stones, but while their number was small, cholesterol stones were more frequent. The low incidence of pure cholesterol stones may show a bad nutritional condition of our population (poor fat and protein content) and this result is important in order in using the new advance: lithodissolvent drugs.


Studies with biotinylated RBC: (1) use of flow cytometry to determine posttransfusion survival and (2) isolation using streptavidin conjugated magnetic beads. Methods are reported for the quantitation and isolation of biotinylated red blood cells (B- RBC). The first method is for determination of posttransfusional survival of rabbit RBC by flow cytometry. The survival of B-RBC was measured using both fresh and paraformaldehyde-fixed cells with similar results. The posttransfusion survival of rabbit RBC measured in this way was normal. There was no indication of increased cell destruction due to antibodies directed against B-RBC and no evidence for loss of biotin from circulating cells. The second methodology is for the isolation of B-RBC from blood with streptavidin-coated magnetic beads. At least eighty percent of positive cells were recovered with very few false positives. Both methods may be helpful in the study of resealed erythrocytes.


Single cell analysis of factors increasing the survival of resealed erythrocytes in the circulation of mice. Erythrocytes labeled with fluorescent membrane markers were reinfused into mice. Blood samples removed periodically were analyzed by flow cytometry for survival of labeled cells. Normal erythrocytes labeled with the markers persisted in the circulation for 45 days. A fraction of lysed and resealed erythrocytes labeled with marker were rapidly cleared from the circulation; the remainder were removed at approximately the same rate as normal cells in the same animal labeled with marker of another color. Lysis in a minimal volume of buffer and addition of ATP during lysis both increased the fraction of cells surviving initial clearance.


Entrapment of purified alpha-hemoglobin chains in normal erythrocytes as a model for human beta thalassemia. Entrapment of purified alpha-hemoglobin chains within normal erythrocytes resulted in structural and functional changes very similar to those observed in human beta thalassemic erythrocytes (Table 1). Membrane proteins and reactive thiol groups were decreased in a pattern similar to that observed in vivo in beta thalassemia. In addition, the alpha-chain loaded cells exhibited evidence of enhanced oxidant stress. Functionally, entrapment of alpha-chains resulted in the loss of cellular and membrane deformability, an important pathologic characteristic of the beta thalassemic erythrocytes. These results also demonstrate that the loss of membrane proteins and thiols as well as the functional loss of cellular and membrane deformability characteristic of the beta thalassemic cell occur very rapidly in the presence of soluble alpha-chains. Utilizing this model of the thalassemic erythrocyte, it is now possible to directly investigate the mechanisms underlying the cellular pathophysiology induced by excess alpha-chains. An understanding of these mechanisms may allow for the development of therapeutic interventions that would improve effective erythropoiesis and prolong erythrocyte survival in the peripheral circulation of individuals with beta thalassemia. Successful therapeutic interventions would diminish the frequency and/or necessity of blood transfusions and chelation therapy in beta thalassemia.


Antagonism of the lethal effects of cyanide with resealed erythrocytes containing rhodanese and thiosulfate. A new concept has been presented for the antagonism of cyanide and possibly other chemical toxicants. Until now, only a half dozen truly specific "antidotes" were known. There are many other "antidotes" which merely prevent the absorption or enhance the elimination of a toxic compound rather than specifically destroying the substance to prevent its toxic effect. This new approach has considerable conceptual significance in toxicology, as it suggests the encapsulating other enzymes to degrade various other chemical toxicants. There are many chemical toxicants for which there are no specific antidotes, and the conceptual approach of employing erythrocyte-encapsulated enzyme provides an innovative, specific approach to antagonize the toxic and lethal effects of these chemicals.


IHP entrapment into human erythrocytes: comparison between hypotonic dialysis and DMSO osmotic pulse. Three different blood units were treated separately by the hypotonic dialysis (HD) and the dimethylsulphoxide osmotic pulse (DMSO) method, in order to load the erythrocytes with inositol hexaphosphate. A detailed comparison between the two loading techniques was performed by monitoring the red cell distribution patterns on discontinuous Percoll density gradients, the RBC oxygen affinity and the amount of the main intracellular organic phosphates with the 31P-NMR. The results obtained showed that: (1) The HD loading produces a redistribution of the RBC fractions with a concomitant smoothing of the relative differences among distinct fractions (2) only a minor portion of erythrocytes (from 8.5 to 24.9% of total RBCs) are loaded with IHP after the DMSO treatment. All of these cells move to the lightest fraction (d = 1.080 g/ml). (3) Both HD and DMSO IHP-loaded cells show an increase in P50 (basal vs. after loading, means +/- SD: 25.8 +/- 3.0 vs. 52.5 +/- 3.2 mm Hg) correlated to the IHP incorporation (mean intracellular IHP concentration: 4.2 mmol/l RBC). (4) probably the IHP incorporation efficiency could be probably improved at least by increasing the IHP concentration during the treatment.


Erythrocytes as carriers of new anti-opioid prodrugs: in vitro studies. In using a reversed hypoosmotic lysis and resealing process, internalization of Naloxone or Naltrexone prodrugs as new opioid antagonists into red blood cells (RBC) can be obtained. We describe the entrapment method and haematological parameters of such RBC carriers. Percentages of internalization range between 35% and 70%, depending on the prodrug. The stability of the different prodrugs within RBC, after in vitro internalization have been compared at 4 degrees C and 37 degrees C. These studies were performed in order to screen and choose the most interesting prodrugs for in vivo studies. Some prodrugs tested appeared to be stable after 24 hours of incubation, but others were not. The intracellular ATP and 2,3 BPG concentrations of RBC carriers were similar to the control.


Sickle cells modified by an osmotic pulse in the presence of inositol hexaphosphate have decreased intracellular hemoglobin concentration and decreased in vitro sickling without prolonged in vivo survival. An osmotic pulse was used to modify red blood cells (RBC) from two patients with sickle cell disease, resulting in an increased volume and decreased hemoglobin content. This treatment yielded cells which were divided into two populations, one in which RBC had markedly decreased hemoglobin concentration and another in which the cells appeared to be unmodified. Morphological sickling at low oxygen partial pressure was markedly decreased. However, there was no evidence for increased RBC lifespan when the 51Cr-labeled, modified cells were reinfused.


Properties of hypotonized, crosslinked and crosslinked- permeabilized rat erythrocytes as potential carrier systems. The osmotic fragility curves of isotonic rat RBCs, studied at pH 8 to avoid the Hb insolubility, are similar to those in humans at pH 7.4. Hypotonized rat RBCs, either directly or dialysed (0-24 h), are more hemolysis-resistant than isotonic rat RBCs. The discocyte-stomatocyte-spherocyte transformation can be observed with scanning electron microscopy. Protein crosslinking with dimethyl suberimidate can stabilize RBCs. The crosslinking level (60%), the cellular yield (80%), the mechanical and hemolytic resistance and the protective effect of enzyme activities, were studied in crosslinked or crosslinked- permeabilized RBCs after digitonin treatment. The normal discocytic shape of RBCs under scanning electron microscopy becomes stomatocytic in crosslinked and crosslinked- permeabilized RBCs with an erosioned surface.


Induction of T helper cells and cytokines for mucosal IgA responses. CD4+ Th cells and their derived cytokines play an important role in the regulation of IgA responses in the mucosal immune system. Th1 and Th2 cells induce different Ig isotype and IgG-subclass responses. Further, cytokines produced by Th2-type cells (e.g., IL-5 and IL-6) have been shown to induce PP sIgA+ B cells to secrete IgA. Our studies have now shown that oral immunization with SRBC selectively induces Th2-type cells in PP while systemic (I.P.) immunization with SRBC predominantly induces Th1-type cells. It is tempting to suggest that Th2 cells which produce IL-5 and IL-6 tend to be predominant in mucosal effector regions, such as the salivary glands and LP tissues and account for the predominant IgA responses which characterize these tissues. The PP contain B cell subsets which respond to IL-5 and IL-6, and these are largely restricted to the PNALo non-GC (memory) sIgA+ B cells. The importance of CD4+ Th cells in the regulation of IgA responses has also been shown by the depletion of CD4+ Th cells in anti-L3T4 (CD4)-treated mice. Loss of CD4+ Th cells from mucosal tissues resulted in dramatically decreased numbers of IgA plasma cells in the small intestine and led to a reduction in IgA SFC in isolated LP cells. The overall size of PP was reduced and the GCs were absent; however, the relative frequency of sIgA+ B cells in PP did not change, possibly suggesting that CD4+ Th cells do not influence switches to IgA.