Hepatic artery aneurysm

A 67-year-old man presented with epigastric pain and underwent cholecystectomy for acute acalculus cholecystitis. Exploration revealed a large aneurysm in the hepatic artery. One week later, the patient developed jaundice, ascending cholangitis and common bile duct obstruction. He was treated with percutaneous transhepatic drainage with dramatic improvement, then underwent an emergency aneurysm resection operation. He is now well, 8 months postoperatively. Due to the high mortality rate associated with hepatic artery aneurysm, treatment is primarily surgical with aneurysmorrhaphy or direct arterial reconstruction utilizing either autogenous saphenous vein or prosthetic grafts. For inaccessible aneurysms or when patients are unfit to withstand surgery, embolization is a useful alternative.

Distribution of dystrophin, nebulin and Ricinus communis I (RCA-I)-binding glycoprotein in tissues of normal and mdx mice

Dystrophin, the protein product of the Duchenne muscular dystrophy (DMD) gene locus, appeared as an immunoreactive triplet of polypeptides in striated muscle tissues from normal mice on Western blot analysis. In smooth muscle tissues, an immunoreactive doublet of corresponding molecular weight was detected. No dystrophin was found in normal mouse brain, not even after enrichment for the Triton X-100 insoluble fraction. Dystrophin was absent from all corresponding tissues from the mdx mutant mouse strain which is known to lack dystrophin. The possibility that these immunoreactive bands represent isoforms is discussed. We have also investigated two other high molecular weight proteins which show secondary abnormalities in DMD muscle, namely nebulin and the 370 kDa Ricinus communis I lectin (RCA I)-binding glycoprotein. Nebulin levels were reduced in skeletal muscle from 6-week-old mdx mice but not in oesophagus from the same animals. By contrast, the RCA I-binding 370 kDa glycoprotein which is greatly reduced in DMD skeletal muscle was present in normal amounts in mdx skeletal muscle. These findings show, for the first time, that mdx myopathy differs from DMD myopathy not only morphologically, but also in its secondary biochemical abnormalities.

[Membrane changes in Duchenne/Becker muscular dystrophy: lectin binding and localization of dystrophin]

An RCA I-lectin binding glycoprotein of Mr = 370 kD is missing from or altered in the plasma membrane of Duchenne muscular dystrophy (DMD) skeletal muscle. In the present study the carbohydrate chain of this glycoprotein was localized to the external face of the plasma membrane in human skeletal muscle, and dystrophin, the protein product of the DMD gene, was localized to the inner (cytoplasmic) face. On double labelled Western blots the two proteins appeared as closely apposed but distinctly separate bands. Comparison of the plasma membrane binding of five lectins with overlapping sugar specificities in skeletal muscle from patients with DMD and the allelic milder disease form, Becker muscular dystrophy (BMD) showed that the RCA I-binding glycoprotein also strongly binds to phytohaemagglutinin, thereby largely characterising the carbohydrate binding site. This glycoprotein was absent or altered in DMD and markedly reduced in clinically manifest BMD but present in preclinical clinical BMD. There was no general depletion of plasma membrane glycoproteins in DMD because consistent plasma membrane binding could be demonstrated by peanut and maclura pomifera lectin. The possible implications of these findings for the pathogenesis of DMD/BMD are discussed.

Physicians and DRGs. Hospital management alternatives

Rising health care costs in general and hospital costs in particular have placed significant financial strain on federal programs such as Medicare. It was with this in mind that the Reagan administration in 1983 initiated Medicare's new prospective payment system based on diagnostic-related groups (DRGs) to reduce the growth rate of Medicare expenditures. The introduction of DRGs has generated significant controversy in the health care community. The DRG system may necessitate consideration of four new management alternatives by hospital administrators: increased monitoring and regulation of physicians, profit-loss sharing arrangements between physicians and hospital management, development of collective protocols among physicians, and bedside budget balancing. This study examines the opinions of a random sample of 838 physicians from the West North-Central region regarding these management alternatives. The findings suggest that physicians have strong negative opinions about these management alternatives and believe that they will have a negative impact on the health care system. The development of collective protocols emerges as the most likely acceptable alternative among physicians, but even collective protocols as an alternative promise limited success.

Dystrophin and nebulin in the muscular dystrophies

Skeletal muscle from patients with 5 different forms of muscular dystrophy and from 6 fetuses at high risk (95%) for Duchenne muscular dystrophy (DMD) were probed with specific antibodies for the presence of dystrophin and nebulin. Dystrophin was absent in all 5 patients with DMD and 4 of 6 fetuses at high risk for DMD and present in trace amounts in the remaining two. Dystrophin was also undetectable in one borderline DMD/Becker muscular dystrophy (BMD) case and reduced in 2 of 4 cases of BMD. In contrast, dystrophin was present in all 16 biopsies from 4 other types of muscular dystrophy (congenital, limb girdle, Emery-Dreifuss and facioscapulohumeral). Nebulin profiles varied with the type, severity and duration of the dystrophic process. Nebulin was present in 5 of 6 DMD fetal samples but vastly reduced or absent in all samples of clinically manifest DMD.

Dual-label autoradiographic analysis of human skin fibroblast and myoblast proteins by two-dimensional polyacrylamide gel electrophoresis using immobilised pH gradients in the first dimension

Horizontal two-dimensional polyacrylamide gel electrophoresis with immobilised pH gradients in the first dimension has been applied to the analysis of human skin fibroblast and muscle myoblast total cell proteins. Excellent two-dimensional separations of skin fibroblast proteins were obtained using pH 4-10 immobilised pH gradient gels with a long interelectrode distance (16 cm), but resolution was degraded, particularly of the more acidic proteins, by the use of shorter (10 cm) gels. Improved resolution of acidic and basic proteins was obtained using separate pH 4-7 and pH 7-10 immobilised pH gradient gels respectively in the first dimension. Two-dimensional protein maps of skin fibroblast proteins were visualised both by silver staining and by autoradiography of samples labelled synthetically with [35S]methionine. Horizontal two-dimensional electrophoresis, using pH 4-7 and pH 7-10 immobilised pH gradient gels in the first dimension, was applied to the analysis of protein samples from skin fibroblasts and muscle myoblasts dual-labelled synthetically with [35S]methionine and [75Se]selenomethionine in an attempt to identify sets of proteins specific to each cell type. In addition, two-dimensional maps or protein samples derived from normal individuals and patients with Duchenne muscular dystrophy were compared to search for protein changes associated with the disease state. Although sets of qualitative protein spot differences were observed by visual inspection of the two-dimensional gels, more rigorous qualitative and quantitative analysis of the patterns using a computerised analysis system will be required to obtain the maximum amount of information from these data.

Calmodulin-binding profiles for nebulin and dystrophin in human skeletal muscle

Nebulin and dystrophin are two high-molecular-mass skeletal muscle proteins that have both been associated with the defective gene in Duchenne muscular dystrophy, although the function of neither protein is known. Other high-molecular-mass, calmodulin-binding proteins have recently been implicated in regulating calcium release from skeletal muscle. Western blots of human skeletal muscle biopsy samples were probed with biotinylated calmodulin; nebulin was identified as a prominent high-molecular-mass calmodulin-binding protein but dystrophin did not bind detectable amounts of biotinylated calmodulin. Dystrophin was absent in a Duchenne muscle biopsy.

Computed tomography in the evaluation of adrenal glands in infants and children

The most sensitive indicators of an abnormal adrenal gland have been a change in the margin of the gland from concave or straight to convex, and the presence of calcification. Large adrenal glands that have preserved normal shape and in postintravenous enhancement show homogeneous increased density indicate hyperplasia.

A comparative study of protein synthesis by keratinocytes and fibroblasts in vitro using two-dimensional gel electrophoresis and dual isotope autoradiography

A procedure is described for the detection of keratinocyte specific proteins. Fibroblasts and keratinocytes were isolated from human skin and radiolabelled in vitro. Samples were separated by two-dimensional polyacrylamide gel electrophoresis to compare the proteins synthesised by the different types of cultured skin cells. Dual label autoradiography of samples radiolabelled with [35S]methionine and [75Se]selenomethionine was used to identify keratinocyte specific proteins. We report 45 keratinocyte-specific components and identify some of these proteins. The differential expression of these proteins and their relevance to epidermal differentiation are discussed.

Hybrid Isoelectric Focusing Using Mixed Synthetic-Carrier Ampholyte-Immobilized pH Gradient Gels

An exciting recent innovation in isoelectric focusing (IEF) has been the development of Immobiline reagents (LKB) (1) for the preparation of polyacrylamide gels containing immobilized pH gradients (IPGs). The Immobilines are a series of seven acrylamide derivatives with the general structure: [Formula: see text] where R contains either a carboxyl (acidic Immobilines) or a tertiary amino (basic Immobilines) group, forming a series of buffers with different pK values (3.6, 4.4, 4.6, 6.2, 7.0, 8.5, 9.3). IPGIEF gels are prepared in the same manner as conventional gradient polyacrylamide gels using a concentration gradient, stabilized with a density gradient (e.g., glycerol), of the Immobiline reagents mixed with acrylamide and N,N'-methylene bisacrylamide (Bis) under the control of a suitable gradient forming device. Thus, during polymerization the buffering groups forming the pH gradient are covalently attached and immobilized via vinyl bonds to the backbone of the polyacrylamide matrix.

Detection of proteins in polyacrylamide gels using an ultrasensitive silver staining technique

Polyacrylamide gel electrophoresis is a versatile and powerful tool for the analysis of biological samples and is capable of good separation and high resolution of complex protein mixtures. Although Coomassie Brilliant Blue R250 has proved ideal as a general protein stain for the more traditional applications of this method, current trends toward thinner gels, decreased sample loading (to improve resolution), and the recent developments of two-dimensional gel electrophoresis and peptide mapping techniques have necessitated increasingly sensitive detection methods. Electrophoretic separation of radioactively labeled proteins followed by autoradiography permits the detection of trace proteins (10(-4) to 10(-5)% of total protein) in a sample (1). However, problems inherent in radioactive methods include: (a) in vitro labeling may alter physical properties of proteins, and (b) in vivo experiments require excessively large quantities of isotopes that are prohibitively expensive in animals and unethical in human clinical studies. Alternative methods such as fluorescent staining (2) and heavy metal stains (3) are of less than, or at best of equivalent sensitivity to, Coomassie Brilliant Blue R250.

Two-Dimensional Electrophoresis Using Immobilized pH Gradients in the First Dimension

The high-resolution capacity of two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) based on the method of O'Farrell (1) makes it the method of choice for the analysis of complex protein mixtures (2-4). In the standard procedure, cylindrical tube isoelectric focusing (IEF) gels are used. Unfortunately this system suffers from severe cathodic drift resulting in pH gradients that do not extend above pH 8, resulting in concomitant loss of basic proteins from 2-D maps. Gradients can be extended to pH 10 by special treatment of the glass IEF tubes (5) or by using a horizontal flat-bed IEF (5-7). In spite of the improvement in resolution of basic proteins that can be achieved with these procedures, difficulties are still associated with the first-dimension IEF gels as a consequence of the characteristic properties of the synthetic carrier ampholytes used to generate the pH gradients. These include problems of batch reproducibility of ampholytes, irreproducibility of separations, difficulty in control of pH gradient stability and shape (i.e., "pH gradient engineering"), and the possibility of artifacts caused by protein-ampholyte interactions.

Two-dimensional polyacrylamide gel electrophoresis using flat-bed isoelectric focusing in the first dimension

Electrophoretic techniques are, perhaps, the most important group of procedures for the separation and analysis of complex protein mixtures because of their high resolution capacity. This resolving power is maximized in high-resolution, two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) based on the technique developed by O'Farrell (1). This methodology involves a combination of a first-dimension separation in cylindrical isoelectric focusing (IEF) gels containing 9M urea and 2% (w/v) of the detergent NP-40 with discontinuous gradient polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate (SDS-PAGE) in the second dimension. Detailed reviews of the theoretical basis, methodological variations, and applications of this technology can be found in refs. 2-5.

Computed tomography, management, and follow-up in infantile hemangioendothelioma of the liver in infants and children

Hepatic hemangioma (hemangioendothelioma) is a rare but most common benign vascular tumor of the pediatric age group. Prompt diagnosis and treatment prevent complications. Familiarity with various CT patterns should facilitate correct diagnosis of hemangioendothelioma of the liver in infants and children and avert angiography.

Fluorometer based multi-parameter analysis of phagocytic cell activation

Simultaneous measurements of the calcium rise, membrane potential change, and 90 degrees light scatter (shape change) responses exhibited by neutrophils upon activation, can be obtained with identical result as that obtained when independently performing each measurement. The putative intracellular mediator diacylglycerol depolarizes membrane potential and causes a decrease in light scatter. Leukotriene B4 causes a rise in calcium and a decrease in light scatter. The chemotactic peptide, N-formylmethionyl-leucyl-phenylalanine, causes a depolarization of membrane potential, a calcium rise, and a decrease in light scatter. The fura 2 measurements of intracellular free calcium indicate that the calcium concentration of unstimulated cells is much lower than previously thought based on quin 2 studies.

Is nursing a profession? Results of a Missouri study

This article examines the question of whether or not nursing is or should be a profession. The conclusion is based primarily on an analysis of what constitutes a profession and an empirical study of some nursing practices and attitudes. The analysis of professions recognizes three prominent models in sociology: trait, functional, and power or control. It bypasses these in favor of a "cluster concept," which asserts that the public has a number of expectations of an occupation before it will bestow the status of profession upon it. We then give an analysis of some of the results of the survey of a sample of Missouri registered nurses. The gist of the data is said to reflect the facts that these nurses think nursing is or should be a profession, but that other factors tend to show that nursing lacks the requisite cluster to substantiate the claim to be a profession. We conclude that nursing should perhaps not be a profession since it has been a bastion of the "ethics of compassion" in a world that is increasingly beset by an "ethics of competence."

Rapid commercial test for direct detection of group A streptococci in throat swabs

The Hybritech Strep A ICON was used for direct testing of 1016 throat specimens for group A beta-hemolytic streptococci. Both the test and culture were negative in 829 specimens (81.6%); both were positive in 164 cases (16.1%); the test was positive and culture negative in 9 cases (0.9%); and the test negative and culture positive in 14 cases (1.4%).

In vivo study of an antimicrobial surgical drape system

We performed a double-blind clinical study to determine the efficacy of nonwoven laparotomy drapes in which 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride, an antimicrobial agent, was chemically bonded to the absorbent reinforcement surrounding the fenestration. The reinforcement portion of the surgical drape that contained the fenestration was segmented into four identical-appearing sections, two on each side of the fenestration. One segment on each side was antimicrobial. The locations of the treated segments were randomly varied. At the end of each operation, test strips were removed. Bacteria were harvested from each segment by mechanical agitation. Bacterial CFU were counted. There were 110 surgical cases in the study, including clean, clean contaminated, and contaminated procedures. Data analysis divided the cases into two distinct groups. Group 1 was composed of 59 cases in which less than 30 total CFU was recovered from the four test samples. The average duration of surgery for this group was 1.8 h. Group 2 was composed of 51 cases in which bacterial recovery was in excess of 30 CFU per procedure (range, 30 to 25,000 bacterial CFU). The average duration of surgery was 3.3 h. Bacterial reduction in the treated strips was 84%. The most common organisms identified on the laparotomy drapes were Staphylococcus epidermidis, S. hominis, and Micrococcus luteus. This study demonstrated that the reinforcement of a laparotomy drape is a reservoir for potential pathogens. It demonstrated that an organosilicon quaternary ammonium antimicrobial agent covalently bonded to the reinforcement reduced the number of potential pathogens surrounding the surgical incision by 84%, independent of the size of the bacterial challenge.

Clinical trial of captopril (Aceten) in Indian patients with essential hypertension

ACE inhibitors are not available in India. Response to captopril in comparison with M-dopa was therefore seen in Indian hypertensive patients. A double blind randomized non-crossover study was carried out on 39 adult patients of either sex suffering from essential hypertension. Twenty-five patients included were resistant to earlier drug therapy. The remaining 14 were freshly detected hypertensive patients. Patients received either 150 mg/day captopril (Aceten) or 750 mg/day M-dopa in 3 equally divided doses every day for 30 days. The mean systolic and diastolic blood pressure in captopril (Aceten) group before starting drug therapy was 171 +/- 4.11 (mean +/- SE) and 111 +/- 0.22, respectively. At the end of therapy the systolic blood pressure was 132 +/- 1.86 and diastolic blood pressure was 84 +/- 1.36 mm of mercury. This fall in the blood pressure within the group was statistically highly significant (p less than 0.001). Similarly patients on M-dopa produced statistically highly significant fall in blood pressure (p less than 0.001) at the end of 4 weeks therapy. Initial systolic and diastolic blood pressure in both groups were comparable and, at the end of 2 and 4 weeks therapy, patients on captopril (Aceten) showed greater fall in both systolic (p less than 0.001) and diastolic (p less than 0.005) blood pressure than patients on M-dopa. None of the patients in the trial demonstrated clinically significant changes in the biochemical parameters. Six of nineteen patients on methyl dopa had side effects which are well known to this drug. None in the captopril showed any side effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Single-dose trimethoprim-sulfamethoxazole prophylaxis for cesarean section

Single-dose trimethoprim-sulfamethoxazole prophylaxis after clamping of the umbilical cord decreased the rate of endomyometritis in high-risk patients by 50% when compared with placebo. This drug combination may affect the normal flora of the cervix the least so that superinfections should be rare.

Interaction of influenza virus haemagglutinin with cell membranes

Influenza virus causes susceptible cells to undergo haemagglutination, haemolysis and oxygen radical formation. Each activity is the result of an interaction between the haemagglutinin (HA) glycoprotein and the cell plasma membrane, and appears to involve three discrete functions of the HA glycoprotein.

Permeability changes elicited by influenza and Sendai viruses: separation of fusion and leakage by pH-jump experiments

Permeability changes elicited in Lettre cells by influenza virus at pH 5.3 were maintained when the pH was shifted to 7.4. Permeability changes elicited by Sendai virus at pH 7.4 were maintained when the pH was shifted to 5.3. In each case permeability changes at the new pH were sensitive to inhibition by extracellular Ca2+. The time at which the pH was shifted was critical: if the shift was made prior to the onset of permeability changes, no subsequent changes occurred. It is concluded that the pH-sensitive event, namely virus-cell fusion, is related to the induction of permeability changes through attainment of some type of 'threshold' level of membrane damage.

Relationship of oxygen and glutathione in protection against carbon tetrachloride-induced hepatic microsomal lipid peroxidation and covalent binding in the rat. Rationale for the use of hyperbaric oxygen to treat carbon tetrachloride ingestion

CCl4 exerts its toxicity through its metabolites, including the free radicals CCl3. and CCl(3)00.. Oxygen strongly inhibits the hepatic cytochrome P-450-mediated formation of CCl3. from CCl4 and promotes the conversion of CCl3. to CCl(3)00.. Both these free radicals injure the hepatocyte by causing lipid peroxidation and binding covalently to cell structures. A reduced glutathione (GSH)-dependent mechanism can protect the liver microsomal membrane against CCl4-induced damage under aerobic conditions but not under anaerobic conditions (Burk, R.F., K. Patel, and J.M. Lane, 1983, Biochem. J., 215:441-445). Experiments were carried out using rat liver microsomes to examine the effect of O2 tensions found in the liver and of GSH on CCl4-induced covalent binding and lipid peroxidation. An NADPH-supplemented microsomal system was used. CCl4 or 14CCl4 was added to the sealed flask that contained the system, and after 20 min CHCl3 production, thiobarbituric acid-reactive substances (an index of lipid peroxidation), and covalent binding of 14C were measured. O2 tensions of 0, 1, 3, 5, and 21% were studied. Increases in O2 tension caused a fall in CHCl3 production, which indicated that it decreased CCl3.. GSH had no significant effect on CHCl3 production at any O2 tension. Lipid peroxidation and covalent binding of 14C fell progressively as O2 tension was increased from 1 to 21%. The addition of GSH decreased both lipid peroxidation and covalent binding, but did so better at the higher O2 tensions than at the lower ones. These results indicate that low O2 tensions such as are found in the centrilobular areas of the liver favor conversion of CCl4 to free radical products which cannot be detoxified by the GSH-dependent mechanism. They suggest that hyperbaric O2 might decrease free radical formation in the liver in vivo and promote formation of CCl(3)00. from CCl3.. This should result in diminished CCl4-induced lipid peroxidation and liver damage. Rats given CCl4 (2.5 ml/kg) were studied in metabolic chambers. Production of CHCl3 and ethane, the latter an index of lipid peroxidation, were measured. Rats in two atmospheres of 100% O2 produced much less CHCl3 and ethane than rats in air. This strongly suggests that hyperbaric O2 is decreasing free radical formation from CCl4 and/or promoting the formation of CCl(3)00. from CCl3.. These results provide the rationale for the use of hyperbaric O2 in the treatment of CCl4 ingestion.

Renal and splanchnic circulation during infrarenal aortic cross-clamping

The effect of infrarenal cross-clamping of the aorta on regional splanchnic and renal circulations was studied in seven dogs. Regional blood flow was determined with differentially labeled microspheres (9 and 15 micron in diameter) that were injected simultaneously into the left atrium. Blood flow was measured 30 minutes after surgical preparation was completed (stage I), 20 minutes after infrarenal aortic cross-clamping (stage II), and 20 minutes after supplemented sodium nitroprusside infusion (stage III). Infrarenal aortic cross-clamping was accompanied by a slight increase in the cardiac output (CO) without significant changes in mean arterial pressure (MAP). Blood flow through the gut, hepatic artery, and cortical layer of the kidneys, as determined with 15-micron spheres, was not changed. Nonentrapment of 9-micron spheres in the gut and renal cortex was increased substantially. Blood flow through the juxtamedullary layer of the kidneys was increased. Sodium nitroprusside supplementation decreased MAP by 30%; CO values returned to baseline level. Hepatic artery blood flow, compared with both baseline values and values during aortic cross-clamping, increased significantly. Blood flow, determined with 15-micron spheres, through the gut and renal cortex did not change, and nonentrapment of 9-micron spheres decreased to baseline values. The data suggest a certain shift of blood flow to the juxtamedullary layer of the kidneys during aortic cross-clamping and normalization of intrarenal blood flow distribution during supplemented sodium nitroprusside infusion. Controlled vasoplegia with sodium nitroprusside may help modify peripheral circulatory disturbances in the kidneys and splanchnic system during infrarenal aortic cross-clamping.

Common action of certain viruses, toxins, and activated complement: pore formation and its prevention by extracellular Ca2+

Haemolysis by Sendai virus, alpha-toxin, and activated complement is inhibited by high concentrations of divalent cations. In Daudi cells, sublytic amounts of these agents induce the following changes: collapse of surface membrane potential, uptake of Na+ and loss of K+ from cells, and leakage of phosphorylated metabolites from cells. The changes induced by Sendai virus and complement are sensitive to physiological concentrations of extracellular Ca2+. It is concluded that fluctuations in plasma Ca2+ concentration may affect the damaging action of certain pore-forming agents on susceptible cells.

Reduced glutathione protection against rat liver microsomal injury by carbon tetrachloride. Dependence on O2

Rat liver microsomal membranes contain a reduced-glutathione-dependent protein(s) that inhibits lipid peroxidation in the ascorbate/iron microsomal lipid peroxidation system. It appears to exert its protective effect by scavenging free radicals. The present work was carried out to assess the effect of this reduced-glutathione-dependent mechanism on carbon tetrachloride-induced microsomal injury and on carbon tetrachloride metabolism because they are known to involve free radicals. Rat liver microsomes were incubated at 37 degrees C with NADPH, EDTA and carbon tetrachloride. The addition of 1 mM-reduced glutathione (GSH) markedly inhibited lipid peroxidation and glucose 6-phosphatase inactivation and, to a lesser extent, inhibited cytochrome P-450 destruction. GSH also inhibited covalent binding of [14C]carbon tetrachloride-derived 14C to microsomal protein. These results indicate that a GSH-dependent mechanism functions to protect the microsomal membrane against free-radical injury in the carbon tetrachloride system as well as in the iron-based systems. Under anaerobic conditions, GSH had no effect on chloroform formation, carbon tetrachloride-induced destruction of cytochrome P-450 or covalent binding of [14C]carbon tetrachloride-derived 14C to microsomal protein. Thus, the GSH protective mechanism appears to be O2-dependent. This suggests that it may be specific for O2-based free radicals. This O2-dependent GSH protective mechanism may partly underlie the observed protection of hyperbaric O2 against carbon tetrachloride-induced lipid peroxidation and hepatotoxicity.

Ca2+-sensitive permeability changes caused by influenza virus

Influenza virus added to Lettré cells at pH 5.3 induces a permeability change similar to that elicited by Sendai virus at pH 7.4: K+ and Na+ equilibrate across the plasma membrane and low-molecular-weight phosphorylated compounds leak out of cells, which remain impermeable to trypan blue.

Thromboxane B2 (TxB2) metabolism in rat isolated lung and its inhibition by drugs

In rat isolated lung perfused via the pulmonary circulation, 3H-TxB2 was metabolized to another radioactive species. About 60% of effluent 3H was metabolite and the same proportion of metabolite was found in lung at 5 min after the injection of 3H-TxB2. Metabolism of TxB2 was prevented by bromcresol green, dipyridamole and frusemide apparently by decreasing uptake of TxB2 by the lung. Our results support the possibility of TxB2 competing with PGE2 for metabolism in lung, although TxB2 is not a substrate for PGDH in vitro.

Neuroblastoma, tuberous sclerosis, and subependymal giant cell astrocytoma

A patient with Stage III paratesticular neuroblastoma diagnosed in infancy was treated with radiotherapy and chemotherapy. Typical depigmented "ash leaf" skin lesions of tuberous sclerosis appeared during early childhood. At 7 years of age he underwent craniotomy for a subependymal giant cell astrocytoma. The occurrence of neuroblastoma, tuberous sclerosis, and astrocytoma is unique, and supports the suggested relationship between neural crest tumors and hamartoma syndromes.

Kaposi's sarcoma and T-cell lymphoma in an immunodeficient woman: a case report

The acquired immunodeficiency syndrome has now been reported among more diverse groups of patients, and as each new category of patients is described, additional epidemiological and pathological insights are gained. Adult non-Haitian women with AIDS have so far generally been reported to have had male partners who have AIDS, are intravenous drug users or both. The present case is being reported because she was a non-Haitian, who did not use drugs and denied sexual contact with men. Pathologic and clinical findings in this case are consistent with AIDS and include: early generalized lymphadenopathy, pronounced lymphocytopenia, fever, hepatosplenomegaly, Kaposi's disease present, in lymph nodes, disseminated candidiasis, anergy to skin testing for delayed hypersensitivity reactions.

Intergovernmental relations in physician education and health planning: state adoption decisions and the impact of federal programs

This study seeks to explain states' adoptions of programs in health planning and in physician education. It also seeks to further understanding of the impact of federal health planning and education programs on the states. Several theories and models are employed in analyzing the actions of state decision-makers. These include incremental theory, models of the diffusion of innovations, economic resources theory, and a theory of competitive partisanship. The data utilized in this research were principally derived from intensive interviews with "key" state actors and from historical, documentary materials. Only minimal federal impact appears on states' goals in physician education and health planning. Rather, there is evidence of considerable innovativeness among the states prior to Federal program initiatives. A problem-generated search for solutions seems to be a major source of this innovation. Finally, federal program implementation requirements appear to be a major source of federal--state conflict and opposition.

Carbon monoxide diffusing capacity in polycythaemia rubra vera

The diffusing capacity of the lung, or transfer factor, for carbon monoxide (TLCO) was measured in 12 patients with polycythaemia rubra vera. This was significantly raised (mean 152% predicted, SEM +/- 14%) and remained so even after correction to a standard haemoglobin concentration of 14 . 6 g/dl (mean 139% predicted, SEM +/- 13%). Serial measurements of TLCO on two patients after treatment of polycythaemia rubra vera showed a greater fall in relation to haemoglobin concentration than would have been predicted on theoretical grounds if the increases in TLCO had been due entirely to the increased haemoglobin concentration. The pulmonary capillary blood volume (estimated from TLCO) also fell in these two patients after treatment. There was a strong correlation between TLCO and the technetium-99m-labelled red cell volume for the seven men (r = 0 . 92; p less than 0 . 01) and five women (r = 0 . 99; p less than 0 . 001) when studies were performed on the same day. In patients with polycythaemia rubra vera who have no evidence of coexistent pulmonary disease the pulmonary capillary bed appears to share in the expansion of the body blood volume. The single-breath TLCO test may act as a convenient and simple monitor for the response of the disease to treatment.

Human cytomegalovirus DNA: BamHI, EcoRI and PstI restriction endonuclease cleavage maps

The cloned HindIII fragments of human cytomegalovirus (HCMV) strain AD169 DNA were mapped with respect to the BamHI, EcoRI and PstI restriction endonuclease cleavage sites. Composite restriction endonuclease cleavage maps for the entire virus genome were constructed using the previously established linkages between the HindIII fragments.

Succinylcholine-induced hyperkalemia in the rat following radiation injury to muscle

During anesthetic preparation of a patient who had received routine radiation therapy for sarcoma of the leg, cardiac collapse occurred following succinylcholine (SCh) administration. Experiments were designed to test the hypothesis that radiation injury to muscle might cause increased sensitivity to SCh similar to that reported in patients with muscle trauma, severe burns, and lesions causing muscle denervation. Venous plasma potassium levels and arterial blood gas tensions were measured in rats after they were given SCh (3 mg/kg) at various times following 60Co irradiation of the hind legs. Nonirradiated rats responded to SCh with a slight but statistically significant increase in plasma K+. Rats subjected to high levels of radiation (10,000 to 20,000 R) and given SCh 4 to 7 days later responded in the same way as the control rats. Plasma K+ levels in rats exposed to a fractionated irradiated dosage (2500 R given twice with a 1-week interval) followed by SCh 1 week later were similar to those in the control group, but when SCh was given 2 weeks later (3 weeks after initial irradiation) there was a marked elevation of plasma K+, from 3.6 to 7.7 meq/L, a statistically significant increase.

Acrylonitrile: in vivo metabolism in rats and mice

Acrylonitrile (VCN) is metabolized to cyanide in rats and mice. Cyanide levels following oral administration of an LD50 of VCN or KCN were determined in blood and organs of treated rats and mice. After administration of VCN, cyanide levels were significantly lower than those following treatment with KCN in rats, whereas in mice the difference was not significant. Differences in VCN toxicity signs were observed in rats and mice. In rats, early VCN toxicity signs were cholinomimetic such as: salivation, diarrhea, peripheral vasodilatation, and excessive gastric secretion. These signs differed from the central nervous system disturbances (depression, convulsions and respiratory failure) observed following KCN. In mice, however, the only signs of VCN toxicity were central nervous system effects, identical to those following KCN. Blood cyanide concentrations after VCN were dose-dependent in both species. Maximum blood cyanide concentrations were observed 1 hr after dosing in mice but at 3 hr in rats. Treatments with phenobarbital or Aroclor 1254, or fasting, increased blood cyanide concentrations after VCN. Treatments with cobaltous chloride or SKF 525-A resulted in decreased blood cyanide concentrations after VCN. These data indicate that there are species differences in VCN toxicity and metabolism and suggest that VCN is metabolized to cyanide via a mixed-function oxidase enzyme system.

Acidic phospholipases in cultured human fibroblasts: deficiency of phospholipase C in Niemann-Pick disease

Radioactive phosphatidyl choline substrates specifically labeled in the one position or two position fatty acid were used to establish conditions for the detection of acidic phospholipase A1, A2 and C activities in extracts of cultured human fibroblasts. Maximal activity was detected at a pH of 3.0, 4.0 and 5.0 respectively, suggesting that the enzymes are of lysosomal origin. None of the activities were stimulated or inhibited markedly by Ca2+ or EDTA. The A1 and A2 activities, but not the C activity, were inactivated by the sulfhydryl reactive Ellman reagent. All three enzyme activities were in the normal range for cultured fibroblasts which were deficient in acid lipase, indicating that these activities are not attributable to the acid lipase gene product. Phospholipase A activity was deficient in fibroblast extracts from patients with Niemann-Pick disease, types A, B and C. These data suggest either identity or a genetic relationship between sphingomyelinase and phospholipase C. The activities examined were within the normal range in fibroblasts from patients with neuronal ceroid lipofuscinosis, sea blue histiocyte disease and selected uncharacterized degenerative diseases.

Juvenile rheumatoid arthritis. A comparison of patients from the USSR and USA

Juvenile rheumatoid arthritis (JRA) in the Union of Soviet Socialist Republics (USSR) and the United States (USA) shows a remarkable similarity in age of disease onset, subtype onset, frequency, and most laboratory measurements. There is variation in the therapeutic approach with heavier reliance on aspirin in the USA. The evolution of JRA from onset subtype to final subtype over 5 years was the same in both groups and was independent of the type of therapy.

Variability in gas production by Escherichia coli in enrichment media and its relationship to pH

Variability in gas production in multiple subcultures of Escherichia coli was assessed in two selective enrichment media and in lactose peptone water. Considerable variability occurred with all media at 37 and 44 degrees C. Addition of buffer increased gas production and decreased variability. The relationships between pH, growth, and gas production were complex. In buffered media, viable counts increased by 269 x 10(6) to 382 x 10(6)/U of pH fall, whereas in unbuffered media, they increased by 9.45 x 10(6) to 30.37 x 10(6)/U of pH fall. In buffered and unbuffered media, pH fell as gas production rose. However, variability in gas production among individual subcultures was not associated with changes in pH.