Xerophthalmia clinics in rural eye camps

Even though the primary prevention of many eye diseases can be effectively incorporated into the existing pattern of rural eye camps, efforts in this direction are restrained and insubstantial. We describe our technique and experience in the prevention of xerophthalmia by organising a distinct entity called a xerophthalmia clinic in our eye camps. The clinic consists of an Ophthalmologist or an Ophthalmic assistant who will exclusively examine children who come to the eye camp. This is perhaps, the first report on rural xerophthalmia clinics, in ophthalmic literature. Over a seven year period from 1984 to 1990 we have conducted 71 xerophthalmia clinics amongst the ninty eye camps organised. A total of 11,370 children were examined in the xerophthalmia clinic out of which 18.9% were afflicted with the disease. Therapeutic doses of Vitamin A were administered on the spot to the afflicted and prophylactic doses were administered to the rest. Intensive health education efforts are made through clinics to effectuate change in dietry habits towards consumption of locally grown DGLV (Dark Green Leafy Vegetables) like Anthenum, chenopodium and Amaranthus. A bipronged offensive consisting of mega-dosing and health education is, for the present and the foreseeable future, the best strategy to combat xerophthalmia in this desert region. A year by year breakdown of prevalence rates in the present study shows that in years of severe drought the prevalence of xerophthalmia increases three fold over the non-drought or mild drought years, thereby demonstrating that drought is a substantial risk factor in developing countries leading to vitamin A deficiency and xerophthalmia.

Duration of the preclinical phase of chronic myelogenous leukemia: a case report

The molecular events that allow for clonal expansion of the malignant population in chronic myelogenous leukemia (CML) are poorly understood. Recent experiments in transgenic mice suggest a close temporal relationship between expression of the aberrant protein and manifestation of a hematologic neoplasm that resembles CML; tracing the same phenomenon in humans has not been possible. We studied a patient who underwent autologous bone marrow harvest after completion of chemotherapy and radiation therapy for advanced stage Hodgkin's disease. At the time of harvest his peripheral blood counts and bone marrow were morphologically normal. Sixteen months later he developed the clinical manifestations of CML. Detailed molecular evaluation of the harvested marrow showed that a small number of cells contained the Philadelphia chromosome. The time interval required for expansion of the malignant clone, as suggested by this particular patient, was at least 16 months although it is recognized that this figure may be variable.

Acid-induced death in neurons and glia

Lactic acidosis has been proposed to be one factor promoting cell death following cerebral ischemia. We have previously demonstrated that cultured neurons and glial are killed by relatively brief (10 min) exposure to acidic solutions of pH less than 5 (Goldman et al., 1989). In the present series of experiments, we investigated the relationship between changes in intracellular pH (pHi) and cellular viability. pHi was measured using fluorescent pH probes and was manipulated by changing extracellular pH (pHe). Homeostatic mechanisms regulating pHi in neurons and glia were quickly overwhelmed: neither neurons nor glial cells were able to maintain baseline pHi when incubated at pHe below 6.8. Neuronal and glial death was a function of both the degree and the duration of intracellular acidification, such that the LD50 following timed exposure to HCl increased from pH, 3.5 for 10-min acid incubations to pHi 5.9 for 2-hr exposures and pHi 6.5 for 6-hr exposures. Replacement of HCl with lactic acid raised the LD50 to pHi 4.5 for 10-min acid exposures, but did not change the LD50 for longer exposures: pHi measurements concurrent with extracellular acidification suggested that the greater cytotoxicity of lactic acid relative to that of HCl was caused by the more rapid intracellular acidification associated with lactic acid. The onset of death after exposure to moderately acidic solutions was delayed in some cells, such that death of the entire cell population became evident only 48 hr after acid exposure. During this latency period, cellular viability indices and ATP levels fell in parallel.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigen-induced mediator release in primates

We examined the release of bronchoactive mediators into the airways of allergic primates during the acute response to specific antigen inhalation. Twelve adult male cynomolgus monkeys (Macaca fascicularis) with a naturally occurring respiratory sensitivity to inhaled Ascaris suum extract were anesthetized and intubated for each study. Respiratory system resistance (Rrs) and dynamic lung compliance (CLdyn) were measured before and after antigen inhalation, and the release of mediators into the airways was assessed by bronchoalveolar lavage (BAL). BAL samples were concentrated approximately 5-fold before quantitation of LTC4 and PGD2 by RP-HPLC and radioimmunoassay and histamine by a fluorometric assay. Antigen inhalation resulted in a 40-fold increase in BAL levels of i-LTC4 (1.5 +/- 0.7 to 41.6 +/- 12.7 ng, p less than 0.01), a 10-fold increase in i-PGD2 (2.4 +/- 0.9 to 25.9 +/- 5.5 ng, p less than 0.01), and a 20-fold increase in BAL histamine (1.0 +/- 1.5 to 21.4 +/- 2.3 micrograms, p less than 0.01). Dexamethasone (n = 7) inhibited the antigen-induced increase in BAL i-LTC4 (71 +/- 6%, p less than 0.01) and i-PGD2 (52 +/- 8%, p less than 0.05) while weakly inhibiting histamine release (43 +/- 10%). Indomethacin (n = 7) had a variable effect on i-LTC4 levels (6 +/- 51%), strongly inhibited i-PGD2 (88 +/- 9%, p less than 0.01), and had no effect on histamine release (25 +/- 8%). Pretreatment with iodoxamide tromethamine significantly blocked the release of each mediator, but mepyramine, an H1 antagonist, had no effect on mediator release.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary lymphoma of bone: a clinicopathologic study of 25 cases reported over 10 years

Twenty-five cases of primary lymphoma of bone (PLB) reported over a 10-year period were reviewed. The presenting symptom was related to involvement of a single bone with or without regional nodal disease. None showed dissemination of lymphoma in the subsequent six months. Patients affected were 7-65 years of age. An equal predilection for the axial and appendicular skeleton was noted. Histologically, the commonest subtype was diffuse histiocytic lymphoma (DHL, 17 cases), whereas four were poorly differentiated lymphocytic (PDL) type and another four were unclassifiable. Follow-up was available in 18 out of 25 patients for periods ranging from 7 months to 8 years. On clinicopathologic correlation we found that 75% of disease-free patients had a DHL whereas 60% of those alive with disease had a PDL. This study reiterates the view that PLB has a good prognosis and the DHL subtype is especially amenable to complete eradication.

Two unusual cases of pneumatosis coli

We present two patients with pneumatosis coli. The first patient demonstrates the variable distribution of gas cysts prior to spontaneous resolution. The second case presented with colonic obstruction due to gas cysts at the recto-sigmoid junction.

Stress-induced peptide release from rat intermediate pituitary. An ultrastructural analysis

We tested the hypothesis that acute restraint stress results in ultrastructural evidence for enhanced release of alpha-melanocyte-stimulating hormone (alpha-MSH) and beta-endorphin from the intermediate lobe (IL) of the rat pituitary. Measurements of plasma alpha-MSH- and beta-endorphin-immunoreactivity (ir) were used to confirm ultrastructural findings. Plasma alpha-MSH-ir was elevated after 20 and 30 min of restraint while plasma beta-endorphin-ir peaked 10 min after the onset of restraint. Ultrastructural analysis revealed a decrease in the content of secretory granules within IL cells of stressed rats. Analysis of Golgi-related immature secretory granules in IL cells indicated that new peptide synthesis was not enhanced after 30 min of restraint. These results confirm previous studies showing an elevation of plasma beta-endorphin and alpha-MSH-ir during acute restraint. Furthermore, these results indicate that quantitative analysis at the ultrastructural level can be used to assess peptide release from IL secretory cells during stress.

Evaluation of the single tube osmotic fragility test in detection of β-thalassaemia trait

NESTROFT (the Naked Eye Single Tube Red Cell Osmotic Fragility Test) is a simpleand inexpensivemethod for detecting the β-thalassaemiatrait in the general population. Its results, however, depend on visual interpretation. We assessed interobserver variability in the recording of results by three individuals on 380 samples of blood collected intravenously. We also tested 745 samples by finger prick using a drop of blood or a uniform (20 μl) volume and found that when a uniform volume was tested the proportion of false positive results was7% (28/380)as compared to 22% (79/365) when a drop was used. We found that although there-was little variation in recording negative results, there was more variation in recording positive or doubtful results.We conclude that when the NESTROFT in field tests is positive or doubtful, then the blood should be further tested in a laboratory for Hb A2 and a uniform volume of blood rather than an arbitrary drop should be used in the test. NESTROFT is suitable for large scale preliminary screening for the β-thalassaemiatrait in India.

Discrimination between HIV-1 and HIV-2-seropositive individuals using mouse monoclonal antibodies directed to HIV transmembrane proteins

Mouse monoclonal antibodies directed against the transmembrane proteins of HIV-1 or HIV-2 provided site-directed, unambiguous discrimination between HIV-1 and HIV-2 antibody-positive sera, when employed in immunoassays as competitive probes against serum antibodies. These monoclonal antibodies mapped to epitopes outside of the well-characterized immunodominant regions (IDR) of the transmembrane proteins. The monoclonal competitive immunoassay was a superior method for discrimination compared with immunoprecipitation of metabolically radiolabeled HIV envelope glycoproteins, Western blot against viral envelope glycoproteins, or noncompetitive enzyme immunoassays employing HIV recombinant transmembrane proteins or synthetic IDR peptides as serological targets. The monoclonal competitive assay was not affected by antigenic cross reactivity or nonspecific reactivity exhibited by selected serum samples toward envelope proteins or peptides, respectively. Results of the monoclonal competitive immunoassay were supported by results of a peptide inhibition assay employing free IDR peptides in competition with IDR peptides on a solid support for binding of serum antibody. IDR peptide inhibition clearly demonstrated non-cross-reactive antigenic specificity of sera toward either the HIV-1 IDR or the HIV-2 IDR. The monoclonal competitive assay also identified samples containing antibody to both HIV-1 and HIV-2 transmembrane proteins. Analysis of these samples by IDR peptide inhibition indicated they contained two distinct, non-cross-reactive populations of antibodies, one directed to the HIV-1 IDR and the other directed to the HIV-2 IDR.

Dicarboxy-dichlorofluorescein: a new fluorescent probe for measuring acidic intracellular pH

Derivatives of fluorescein sensitive to pH are extensively utilized for the determination of intracellular pH (pHi). Available dyes have pKa values of approximately 7.0, and are not well suited for measuring acidic pHi. We examined the fluorescein derivative, 5 (and 6)-carboxy-2',7'-dichlorofluorescein (CDCF) for its potential in the microspectrofluorometric measurement of pHi during acidic conditions. CDCF showed intense fluorescence and pH sensitivity near its "effective" pKa value of 4.2, using a 495/440 nm dual excitation wave-length ratio method. Protein interactions caused fluorescence ratio deviations which were most pronounced at the extremes of pH, whereas calcium and magnesium concentrations had little effect on the fluorescent ratio intensity. Intracellular calibration performed using nigericin in the presence of high potassium eliminated the need to correct for protein interactions, and the ratio method minimized any variations due to dye concentration differences or instrument fluctuation. Intracellular retention of the dye was high, and 95% of the initial signal remained after 1 h. Fluorescence bleaching was 14.5% after 1 h of continuous excitation and cell survival was not affected by dye loading. We conclude that CDCF is an excellent intracellular pH indicator in the pH range of 4-5.

Ultrastructure of the pituitary intermediate lobe in aging rats

The pituitary intermediate lobe, a source of pro-opiomelanocortin (POMC) peptides, was examined with light and electron microscopic techniques in Sprague-Dawley rats aged 5-18 months and Zucker rats aged 18 months. Cysts were common in the intermediate lobe in the Zucker animals, a finding also noted in human pituitary glands by other investigations. The nuclear envelopes were often indented in cells of aging rats, while those of young animals were generally smooth. Lipid droplets and lysosomes, rarely seen in tissue from young animals, were frequently observed in endocrine cells of older rats. Most cells had an abundance of secretory granules, suggestive of enhanced storage of peptides in the cytoplasm. Nerve terminals which were present among endocrine cells contained myelin figures in some of the old rats, and may indicate degenerative changes, while other terminals appeared normal. These morphologic findings suggest that the aging phenomena in intermediate lobe tissue have characteristics in common with nervous tissue, and may also reflect a diminished inhibitory neuroregulation.

Visual status of industrial workers

Two hundred and eighty four industrial workers were screened to determine their visual acuity. Significant visual impairment was observed in 21.8% individuals and moderate impairment in 34.5% of cases. Convergence insufficiency was a problem in 9.86% of the workers. Since uncorrected refractive errors are a prelude to disastrous workplace related eye injuries, it is recommended that prior to job placement all workers undergo visual acuity screening and get their refractive errors rectified.

Neuralgic amyotrophy: a long term follow-up of four cases

Neuralgic amyotrophy or brachial plexus neuralgia is a condition of uncertain etiology. It needs to be differentiated from the usual brachial plexus injuries. Nerves outside the plexus especially the spinal accessory nerve are involved. Neuralgia is also a feature. Four cases were followed-up in detail over a period of two years. The condition usually resolves almost completely on its own.

Mother or market? Effects of maternal employment on the intellectual ability of 4-year-old children

This article uses the 1986 Children of the National Longitudinal Survey of Youth data set to investigate the impact of maternal employment on children's intellectual ability, as measured at the age of 4 by using the Peabody Picture Vocabulary Test (PPVT). Results from multivariate regression analysis show a statistically significant adverse effect of mother's employment on children's intellectual ability, but only for boys in higher income families. Furthermore, the negative impact was related to the timing of maternal employment: employment during the boys' infancy had a statistically significant negative effect on PPVT scores at the age of 4. This pattern was not found for girls, for children in low-income families, or for families in which mothers resumed their employment after the child's first year of life. The impact of other demographic trends in recent years--declining fertility and rising marital instability--are also investigated. The results show an adverse effect of the presence of other siblings on children's PPVT scores; but holding family income constant, the effect of the parents' marital status on children's intellectual ability is not statistically significant. In addition, several family background factors are highly correlated with children's test scores.

School eye health appraisal

School children form an important large target group which must be screened adequately for early detection of eye diseases and prevention of blindness. A total approach in a school eye health programme must include teacher orientation and health education of children in addition to screening for eye diseases. The ocular morbidity pattern in 5135 school children of Jodhpur is discussed in this paper and it is hoped that it will be an indicator to all eye care agencies to help plan their priorities in the delivery of school based eye care.

Experience with the Merck small bowel enema tube

We describe our experience using the Merck 10 French small bowel enema tube in 50 patients. Small bowel intubation was quick and easy to perform, and the tube was well tolerated by our patients. Kinking of the Merck tube was correctable, but prolonged the examination. The examination had to be abandoned in 6% of cases due to retrograde movement of the tube back into the stomach.

The isolation, characterization and application in the Triticeae of a set of wheat RFLP probes identifying each homoeologous chromosome arm

To investigate the use of RFLP analysis in the Triticeae, a set of low copy number probes has been isolated from a wheat cDNA library. The probes identify each of the 14 homoeologous chromosome arms of wheat as determined by analysis of DNA fragments hybridizing to the probes in aneuploid lines of Chinese Spring. These probes can be used in RFLP analyses both for the assignment of homoeology of alien chromosomes or arms added to wheat, and for the determination of chromosome dosage in wheat aneuploids. Different chromosomes from various Triticeae species can therefore be followed in a wheat genetic background using a single technique. The potential uses of the set in facilitating the transfer of alien segments into wheat are outlined.

Pharmacological comparison of active and passive experimental allergic encephalomyelitis in the rat

Models of actively induced and passively transferred experimental allergic encephalomyelitis (EAE) have been compared in the rat. The time of disease onset, severity of clinical symptoms and percent incidence were compared and assessed for their suitability for evaluation of immunosuppressive agents. The passive EAE model had an earlier disease onset (6 +/- 0.1 days) and 100% of the cell recipients (n = 45) developed severe clinical symptoms, including paralysis of the tail and hind limbs. In contrast, the active EAE model had a mean disease onset day of 13 +/- 0.1 and only 53% of the induced rats (n = 85) developed EAE clinical symptoms which were variable. The average symptom score in both models was inhibited by dexamethasone (1 mg/kg/day p.o.; day 0 to 3), methotrexate (3 mg/kg i.p. single dose; day 1) and cyclosporin A (30 mg/kg/day p.o.; day 0 to 7). The above study indicates that the passive EAE model is more advantageous for pharmacologic evaluation of immunosuppressive agents.

Pedunculated squamous papilloma of the laryngopharynx

Pedunculated squamous papillomas usually arise from the soft palate, tonsil or the epiglottis. These lesions can sometimes prove to be fatal. A case of pedunculate squamous papilloma, arising from the laryngopharynx, in a young, mentally retarded female, is presented here. The clinical presentation, the site of origin and the size of the lesion were quite unusual. The narrow base of the pedicle made the intra-oral excision possible.

Subungual keratoacanthoma in the hand

A subungual keratoacanthoma of the thumb with a 5-year follow-up is reported. Recurrence after initial curettage necessitated amputation of the terminal phalanx as definitive treatment. The 22 subungual keratoacanthomas of the hand reported in the literature are reviewed. Although conservative treatment sparing the digit in the form of excision and curettage is recommended as the initial treatment of choice, this uncommon benign, but aggressive, lesion of the nail bed may require amputation of the involved phalanx as definitive treatment.

Isozyme variation and RFLPs at the β-amylase loci in wheat

Forty-one hexaploid wheat genotypes have been examined for RFLPs detected by a β-amylase probe using three restriction enzymes, and for mature grain β-amylase isozyme polymorphism following IEF. The two homoeoallelic series assayed for RFLPs differed: little variation was found at group 2 chromosome homoeoloci, while the group 4/5 chromosome homoeoloci displayed considerable variation. Varieties that displayed a RFLP with one RE almost always did likewise with the other two REs, suggesting that most of the polymorphisms observed were due to large DNA rearrangements. Comparison of the variation in grain β-amylase isozymes with the RFLP results indicated strong associations between particular RFLP and isozyme alleles.

Kaposi's sarcoma of the trachea

The most common tracheal neoplasms are epidermoid carcinomas, papillomas and cylindromas. Kaposi's sarcoma, confined primarily to the trachea, is one of the rarest tumours. The clinical and histological picture of a case of Kaposi's sarcoma of the trachea in a young, pregnant woman, presenting with severe airway obstruction, is described here. The emergency tracheoscopy dislodged a mass from the trachea, which turned out to be a Kaposi's sarcoma on histology. Although Kaposi's sarcoma is one of the manifestations of AIDS, this patient had neither any underlying immunodeficiency nor any skin, visceral or lymphatic lesions.

Disseminated cysticercosis. New observations, including CT scan findings and experience with treatment by praziquantel

Although the symptom complex of disseminated cysticercosis has been well recognized for over half a century, it is not clearly included in recent disease classifications. Three such patients are described whose main features were uncontrolled seizures, progressive dementia, behaviour disorder, muscular pseudohypertrophy, and a relative paucity of localizing neurological signs or signs of raised intracranial pressure. Radiographic calcification in muscles was not seen. A CT scan of the brain showed numerous small discrete lesions. Their attenuation density values were appreciably less than that of calcium and they enhanced slightly with contrast. Magnification revealed that these were scolices within cysticerci. There was no enhancement of the cyst wall and no pericystic oedema. CT scan of muscles showed similar cysticerci producing a 'honeycomb' appearance. This is the first CT demonstration of widely disseminated living cysticerci in brain and muscles. It was confirmed histologically. In the absence of palpable cysticerci, the clinical diagnosis can be missed, although no other disease in its full form presents in this manner. The symptoms are mainly caused by the space-occupying effect of the large number of cysticerci rather than by adjacent tissue swelling such as is seen in the presence of dying parasites. Praziquantel was ineffective and hazardous, causing some known and some previously unreported responses and reactions. All 3 patients died.

In vitro synthesis and processing of components of the Ascaris suum pyruvate dehydrogenase complex

Poly(A)+ RNA was isolated from Ascaris suum body wall muscle and translated in a cell-free rabbit reticulocyte lysate system. Specific antisera and immunoglobulins against the alpha-pyruvate dehydrogenase and dihydrolipoyl transacetylase components of ascarid pyruvate dehydrogenase complex were used to immunoprecipitate individual radiolabelled polypeptides from the in vitro translation mixtures. Both polypeptides appeared to be synthesized as preproteins about 1.5 and 8 kDa larger than the corresponding native proteins. Incubation of the dihydrolipoyl transacetylase preprotein with an ascarid high-speed mitochondrial supernatant fraction resulted in the formation of a polypeptide with apparent molecular weight intermediate in size between the preprotein and the native enzyme. This processing was insensitive to phenylmethylsulfonyl fluoride and leupeptin but was completely abolished by EDTA. These results suggest that in A.suum, as in other organisms, mitochondrial matrix proteins coded by the nuclear genome are synthesized as larger preproteins and processed by a specific, metal-dependent mitochondrial matrix protease.

The estimation of the health production function for low-income working men

Health is an important variable that determines an individual's economic as well as noneconomic well-being. A healthy individual will be more productive, will contribute more toward a nation's economy, and, keeping other things constant, will have a better life overall than a sick individual. But for a low-income individual, health could be even more crucial since it could be a major factor in perpetuating his poverty. If, as a part of our social policy, we would want to improve the economic well-being of poor people, their health in general would need attention. This paper studies the production of health and the demand for medical care of low-income working men. Low-income working men are "medically indigent" because they are not eligible for Medicaid and are not adequately covered by insurance. This study provides insight into what role medical, preventive, and curative care--as well as other socioeconomic variables, such as income and education--plays in the production of the health of low-income men. It also shows the impact of price, income, and other control variables on the demand for medical care.

Immunochemical characterization of the pyruvate dehydrogenase complex in adult Ascaris suum and its developing larvae

Polyclonal antibody was prepared against the pyruvate dehydrogenase complex purified from adult Ascaris suum body wall muscle. The antibody reacted with the E2, X, alpha E1 and beta E1 subunits of the complex in immunoblots of mitochondrial supernatant fractions and homogenates of adult muscle. In addition, the same subunits were observed in immunoblots of homogenates of L3 and L4 ascarid larvae, suggesting that a similar enzyme complex was present in all developmental stages despite their marked differences in energy metabolism. The phosphorylated and dephosphorylated alpha E1 peptides migrated differently during sodium dodecylsulfate polyacrylamide gel electrophoresis and both forms of the enzyme were recognized by the antibody. These results and those obtained with ELISA suggest that both phosphorylated and dephosphorylated forms of the alpha E1 subunit react equally well with the antibody. In immunoblots of adult body wall muscle, the phosphorylated alpha E1 peptide predominated, while immunoblots of L3 larvae contained predominantly the dephosphorylated form. These results reflect the in vivo activity state of the pyruvate dehydrogenase complex in these two stages and suggest that this technique may be useful for determining the activity state of enzyme complex directly from immunoblots of homogenates A. suum and other helminths.

Total and allergen-specific IgE in relation to allergic response pattern following bone marrow transplantation

Total and allergen-specific serum IgE were measured in relation to allergic response pattern before and after bone marrow transplant (BMT) in seven sibling donor/recipient pairs. Two non-atopic recipients developed persistently raised total serum IgE levels but no apparent allergic response after BMT from non-atopic donors; three non-atopic recipients showed raised total serum IgE after BMT, with allergen-specific IgE to the same allergens as their respective atopic donors. A penicillin-tolerant recipient showed clinical sensitivity and specific IgE to penicillin after BMT from a penicillin-sensitive donor, but with this case both donor and recipient showed raised serum IgE levels. One atopic recipient showed decreased total IgE after BMT from a mildly atopic donor. These allergic response patterns could occur as a result of repopulation in the recipient with IgE-specific T lymphocytes having similar regulatory influences as in the donor. The pattern of acquired responses would also be consistent with reconstitution by primed B lymphocytes of donor origin.

Improved purification of the pyruvate dehydrogenase complex from Ascaris suum body wall muscle and characterization of PDHa kinase activity

An improved purification scheme for the isolation of the Ascaris suum pyruvate dehydrogenase complex directly from body wall muscle has been developed which yields a fully activated pyruvate dehydrogenase complex with substantial PDHa kinase activity. The apparent Km for coenzyme A (CoA) is much lower than previously reported and can only be accurately measured in the presence of a CoA-regenerating system. The alpha-pyruvate dehydrogenase subunit of the ascarid complex is unique and its migration on sodium dodecylsulfate polyacrylamide gels is altered after phosphorylation. PDHa kinase activity is inhibited by ADP, thiamine pyrophosphate, and physiological levels of pyruvate and propionate. In contrast, PDHa kinase activity is stimulated by elevated NADH/NAD+ and acetyl CoA/CoA ratios, although it appears that the NADH/NAD+ ratios required for half-maximal stimulation are more than an order of magnitude greater than those reported for mammalian pyruvate dehydrogenase complexes.

Enzyme-linked immunosorbent assay spin amplification technique for herpes simplex virus antigen detection

A comparative study of herpes simplex virus diagnosis by standard cell culture and a new hybrid test (enzyme-linked immunosorbent assay spin amplification technique) was done on 300 specimens. The new test was found to be equally sensitive and specific, much less expensive to perform, and to report all results in 48 h.

Neonatal neurosonographic correlates of cerebral palsy in preterm infants

Serial neurosonographic examinations are routinely performed at frequent intervals during the nursery course of all preterm infants of 33 weeks or less gestation who are admitted to the intensive care nursery of Thomas Jefferson University Hospital. After discharge, the following survivors during the past 5 years had repeated ultrasound examinations until the anterior fontanel closed and clinical assessments until the presence or absence of cerebral palsy at a minimum age of 12 months was established: all infants with grade III/IV intracranial hemorrhage, periventricular echodensity and periventricular cyst formation, selected infants with either normal ultrasound findings or grade I/II intracranial hemorrhage. Fifteen survivors were found to have cerebral palsy, and all had at least one of the following ultrasound abnormalities: diffuse, bilateral, and multiple periventricular cysts 3 mm or more in diameter that persisted beyond term age, bilateral asymmetrical dilation of the lateral ventricles following grade III intracranial hemorrhage with small periventricular cysts, and ventricular porencephaly following an ipsilateral grade IV intracranial hemorrhage. The periventricular cysts were usually preceded by extensive echodensities of the white matter surrounding the lateral ventricles; these findings were suggestive of periventricular leukomalacia and were the most common abnormal findings on ultrasound in the infants with cerebral palsy. Of 124 infants without cerebral palsy, 121 had no or less severe abnormal findings on ultrasound; the exceptions were three infants with bilateral persistent large periventricular cysts who had normal motor development in late infancy.

Leiomyosarcoma of the inferior vena cava (IVC) with intracardiac extension

A case of leiomyosarcoma of the inferior vena cava showed extension into the right atrium and the right ventricle. Chest roentgenograms, inferior vena cavogram and computed tomography suggested the correct diagnosis and established the extent of involvement. The tumour was successfully removed from the heart with subsequent significant symptomatic relief.

Aminoterminal procollagen III peptide elevation in alcoholics who are selenium and vitamin E deficient

Serum aminoterminal procollagen III peptide (PIIIP) was measured in 36 alcoholic subjects. There was a significant elevation of PIIIP in subjects with proven liver disease (median 17.5 ng/ml, n = 24) compared to those without liver disease (median 4.7 ng/ml, n = 12). Those subjects with raised serum transaminase values (AST) had elevated PIIIP values (median 13.7 ng/ml, n = 22) compared to those with normal transaminase values (median 3.7 ng/ml, n = 14). In those alcoholic subjects who were deficient in both selenium and vitamin E there was a significant elevation (p less than 0.01) of PIIIP values (median 26.4 ng/ml, n = 7) compared to subjects with normal levels (median 7 ng/ml, n = 11). Subjects deficient in selenium alone had PIIIP values in an intermediate range. Selenium and vitamin E, as important free radical scavengers, may protect the liver in alcoholic subjects from oxidative damage leading to hepatic fibrosis.

Primary amyloidosis of ureter

Another case of primary isolated amyloidosis of the ureter is reported; we believe this is the seventeenth such case reported in the world literature. The previous cases are reviewed, and the clinical presentation and treatment are discussed. The importance of distinguishing the condition from transitional cell carcinoma of the ureter is emphasized and a conservative approach to surgical treatment is advocated.

Cranial ultrasound and clinical studies in preterm infants

Serial ultrasound imaging of the brain was used to determine the ventricular index (VI), and the ratio (VR) of the VI to the cranial hemidiameter during the nursery course and first year post-term in preterm infants of less than 33 weeks gestation. Twenty-nine of the infant survivors with no intracranial hemorrhage or major medical complication during their nursery course composed group 1. Twenty-two survivors with intracranial hemorrhage unassociated with early ventricular dilation composed group 2. Group 3 was comprised of 10 other survivors who had neonatal intraventricular hemorrhage with early ventriculomegaly; all 10 infants had at least one major medical complication during their neonatal course. In groups 1 and 2 the VR decreased and the VI increased significantly with age post-conception. Infants in group 3, compared with those in groups 1 or 2, had decreased occipitofrontal growth during the early postnatal period and increased VR and VI during the neonatal period and first year post-term. These results suggest that the ventriculomegaly associated with neonatal intracranial hemorrhage cannot be explained by posthemorrhagic hydrocephalus alone and may also be related to cerebral atrophy or decreased brain growth or both. Neurodevelopmental assessments at 20 to 30 months of age disclosed significantly lower Bayley Motor Development scores in group 3 compared with groups 1 or 2. Four infants in group 3, but none in groups 1 or 2, had cerebral palsy. The neurodevelopmental deficits in group 3 infants may reflect the complex pathogenesis of the ventriculomegaly as well as the effects of the intraventricular hemorrhage and posthemorrhagic hydrocephalus.

Plasma catecholamines in pheochromocytoma: effect of urographic contrast media

Hypertensive crises have been provoked in pheochromocytoma patients by the injection of contrast media during angiography and venography. Fear of similar reactions to intravenous urographic contrast medium injection during computed tomography has led to studies without contrast enhancement when pheochromocytoma is suspected. With extraadrenal pheochromocytomas, intravenous contrast enhancement may be essential for tumor location by computed tomography. The catecholamine responses to injection of urographic contrast medium were examined in eight patients with pheochromocytoma and in 12 undergoing computed tomography for other reasons. Plasma norepinephrine concentrations fell in nonpheochromocytoma patients (p less than 0.005), while in pheochromocytoma patients the response was unpredictable, rising in six individuals, although the mean response was not significant (p greater than 0.35). In five patients the magnitude of the increase in norepinephrine concentrations was large enough to have led to a pressor effect had alpha adrenergic blockade not been used. It was concluded that intravenous urographic contrast medium may elevate plasma catecholamines in a significant proportion of patients with pheochromocytoma, but that with adequate alpha adrenergic blockade this should pose no threat.

Dermatological aspects of the use of Cyclosporin A for prophylaxis of graft-versus-host disease

Oral Cyclosporin A (CyA) was given for the prophylaxis of graft-versus-host disease (GVHD) to sixty-seven patients receiving a bone marrow transplant, and was found to be extremely effective in reducing the severity of acute GVHD. Side-effects of CyA included hypertrichosis, gum hypertrophy, and a rare but serious 'capillary leak' syndrome.

Construction of a cDNA clone for a nuclear-coded subunit of cytochrome c oxidase from rat liver

A cDNA library for 6S-9S poly(A)-containing RNA from rat liver was constructed in E. coli. Initial screening of the clones was carried out using single stranded 32P-labeled cDNA prepared against poly(A)-containing RNA isolated from immunoadsorbed polyribosomes enriched for the nuclear-coded subunit messenger RNAs of cytochrome c oxidase. One of the clones, pCO89, was found to hybridize with the messenger RNA for subunit VIC. The DNA sequence of the insert in pCO89 was carried out and it has got extensive homology with the C-terminal 33 amino acids of subunit VIC from beef heart cytochrome c oxidase. In addition, the insert contained 146 bp, corresponding to a portion of the 3'-non-coding region. Northern blot analysis of rat liver RNA with the nick-translated insert of pCO89 revealed that the messenger RNA for subunit VI would contain around 510 bases.

Comparison of cultures of human lymphocytes obtained following NH4Cl induced red blood cell lysis and Ficoll-Hypaque density gradient centrifugation

Lymphocyte thymidine uptake in leucocytes prepared by NH4Cl induced RBC lysis was compared with that of lymphocytes obtained following Ficoll-Hypaque centrifugation using polynomial regression dose response curves which adjusted for inherent subject variability. Eleven male subjects were studied. Heparinized blood was either layered in Ficoll-Hypaque or treated with 0.87% NH4Cl to induce RBC lysis. Phytohemagglutinin-P (PHA) dose response curves were determined for each subject using triplicate 5 day cultures. For each subject, at each Pha concentration ranging from 12.5 to 167micrograms/ml, triplicate mean cpm of Ficoll-Hypaque treated lymphocytes and NH4Cl treated lymphocytes were compared by the 2 tailed Student's T test. Responses of cultures of NH4Cl treated lymphocytes were significantly different (less than 0.05) from the responses of cultures of Ficoll-Hypaque treated lymphocytes for at least 2 PHA doses in 8 of the 11 subjects. The quadratic dose response curves were also significantly different (p less than 0.05) for 9 of the 11 subjects. A repeated measures quadratic regression was used to determine the best fit dose response curves for each of the experimental conditions. For Ficoll-Hypaque treated lymphocytes, mean cmp=44,977+1400.4 (PHA concentration)-5.90 (PHA concentration)2+ subject effect; s.e.=22,256; for NH4Cl treated lymphocytes, mean cpm=58,039+1022.8(Pha concentration)-5.32 (PHA concentration)2+ subject effect; s.e.=37,966. The p values from the F tests for significance of these quadratic regressions are different, F=1.91, d.f.=30,30; p less than 0.001. The lack of significance of the NH4Cl treated lymphocytes' does response quadratic regression and its larger s.e. indicates that the NH4Cl treated lymphocyte culture dose response curve is less predictable than that of Ficoll-Hypaque treated lymphocytes.