Isolation and characterization of the droPIK57 gene encoding a new regulatory subunit of phosphatidylinositol 3-kinase from Drosophila melanogaster

Mammalian phosphatidylinositol 3-kinase (PI 3-kinase) plays an important role in the regulation of various cellular, receptor tyrosine kinase-mediated processes, such as mitogenesis and transformation. PI 3-kinase is composed of a 110-kDa catalytic subunit and a regulatory subunit of 85 kDa or 55 kDa. We have cloned a gene for a regulatory subunit from Drosophila melanogaster, named droPIK57, from head-specific cDNA libraries. The droPIK57 gene encodes a protein containing two SH2 domains with significant sequence homology to those in p85 and p55. Like the p55 subunits, DroPIK57 is missing the SH3 domain and the bcr homology region of the p85 subunit. The short N-terminus as well as the C-terminus of the DroPIK57 protein show no identity to the known PI 3-kinase subunits, suggesting that it is a new member in the family of regulatory subunits. In-situ hybridization and Northern blot analysis indicate a widespread function of this gene during embryogenesis and in the CNS.

Intensity Measurements of Deltal > 1 Transitions of Several Isotopomers of HCN

The intensities of the forbidden Q-branch transitions 02(2f)0-00(0)0, 12(2f)0-00(0)0, and 02(2f)1-00(0)0 for HCN have been measured. The intensities of the 02(2f)0-00(0)0 transitions of DCN, D13C15N, and H12C15N were also measured, as well as the 02(2f)1-00(0)0 transitions of H12C15N and H13C15N. These Q-branch transitions are forbidden even when the effects of l-type resonance are considered so they must get their intensity from some other Coriolis interactions. The much stronger P- and R-branch lines for the e levels of these same vibrational transitions were also measured and they are shown to get most of their intensity from l-type resonance. However, the same Coriolis resonance that gives intensity to the Q-branch transitions seems to affect the DeltaJ = ±1 transitions as shown by the difference in the intensities of the DeltaJ = +1 and DeltaJ = -1 transitions. Measurements of the intensity of the 03(3e)0-00(0)0 and 03(3f)0-00(0)0 transitions shows that they derive most, but perhaps not all, of their intensity from l-type resonance. An unsuccessful search for forbidden DeltaJ = 0, e-e transitions for the strong 10(0)0-00(0)0 band shows that there is no detectable mixing of the e and f levels. Copyright 1997 Academic Press. Copyright 1997Academic Press

Role of quantitative cultures and microscopic examinations of endotracheal aspirates in the diagnosis of pulmonary infections in ventilated patients

Endotracheal aspirates (EA) from 20 intubated patients in a surgical intensive care unit (mean ventilation time/patient = 16.5 days) were investigated serially by performing quantitative cultures using growth of 10(5) cfu/mL as a cut-off point. Microscopic examinations were made using Giemsa's stain for polymorphonuclear neutrophils (PMN). The spectrum of pathogens encountered was determined and compared with clinical data to distinguish colonization from infection of the lower respiratory tract. Out of 301 EA cultures, 156 (51.8%) were positive and 145 (48.2%) were below the cut-off point. Counts of PMN were significantly higher in samples which gave positive cultures. Seventy-five different bacterial strains were isolated (64% were Gram-negative bacilli). Seventeen patients (85%) were colonized with Gram-negative bacteria. Nine patients (45%) developed nosocomial pneumonia (NP), five (25%) had no signs of pneumonia, and six (30%) had an uncertain status. Main causative agents for NP were Pseudomonas aeruginosa, Enterobacteriaceae and Staphylococcus aureus. Quantitative EA cultures had a sensitivity of 81.5%, a specificity of 64.8%, a positive predictive value of 55% and a negative predictive value of 87%. Our results suggest that EA quantitative cultures (cut-off value 10(5) cfu/mL), species identification and microscopic examination of EA may help to differentiate tracheobronchial colonization and infection, especially when bronchoscopic techniques are not available.

An association between head circumference and Alzheimer's disease in a population-based study of aging and dementia

We investigated the association between head circumference (HC) and Alzheimer's disease (AD) in a cross-sectional population-based study of aging in North Manhattan. Six hundred forty-nine subjects underwent neurologic, neuropsychological, and anthropometric evaluations; apolipoprotein E (apoE) genotype was available for a subsample of 300 individuals. Logistic regression analyses were performed with AD the outcome of interest to evaluate any association between HC and AD. In these analyses, HC evaluated as a continuous variable was associated with AD (OR 0.8, 95% CI 0.7-0.9) after adjusting for age, education, and ethnicity, gender, and height. Analyses suggested that increased risk resided mainly in those with smallest HC. Thus, women whose HC was within the lowest quintile of HC for women were 2.9 (95% CI 1.4-6.1) times more likely to have AD, after adjusting for age, education, and ethnicity; and men in the lowest quintile of HC (for men) were 2.3 times more likely to have AD (95% CI 0.6-9.8). There was no confounding by height, weight, or apoE genotype. The results are consistent with previous studies that suggest that premorbid brain size may influence the age-specific risk for AD. Future epidemiologic studies seeking environmental risk factors for AD may benefit by making HC measurements on all subjects to decrease the variance associated with other potential risk factors.

Cross-cultural neuropsychological assessment: a comparison of randomly selected, demographically matched cohorts of English- and Spanish-speaking older adults

As the US population of elderly Hispanics continues to grow, there is an increasingly greater need for neuropsychological measures that are appropriate for assessing Spanish-speaking elders. The current study compared the performance of randomly selected, community-based samples of English- and Spanish-speaking elders on a brief neuropsychological test battery. Subject groups were matched for age and education. Multivariate analysis indicated significant group differences on the test battery. English and Spanish speakers scored comparably on many language-based tasks, but Spanish speakers scored significantly lower on almost all of the nonverbal measures. Significant group differences were observed on multiple-choice matching and recognition memory for stimuli from the Benton Visual Retention Test, as well as on Identities and Oddities from the Mattis Dementia Rating Scale, category fluency, and Complex Ideational Material from the Boston Diagnostic Aphasia Examination (BDAE). Results suggest that caution is warranted when using nonverbal as well as verbal measures to assess non-English-speaking individuals.

The absence of an apolipoprotein epsilon4 allele is associated with a more aggressive form of Alzheimer's disease

We investigated the relationship between APOE genotype and rate of disease progression and survival in 99 patients with probable Alzheimer's disease (AD) who were followed biannually for up to 6 years. Patients were stratified into two groups, those with and without at least one APOE epsilon4 allele. The rate of decline in modified Mini-Mental State Examination scores was slower, the presence of extrapyramidal signs was decreased, and the development of myoclonus occurred later among patients with APOE epsilon4 alleles compared with patients with other genotypes. Compared with patients without an APOE epsilon4 allele, the risk of mortality was also decreased in patients with at least one epsilon4 allele (RR = 0.38; CI = 0.17-0.84, p < 0.02). Because the decline in mental ability as well as the development of myoclonus and extrapyramidal signs are consistent manifestations of disease progression, our results imply that APOE epsilon4 is associated with a less aggressive form of AD.

BANYULS, a novel negative regulator of flavonoid biosynthesis in the Arabidopsis seed coat

A mutant of Arabidopsis that accumulates a high level of red pigments within the seed coat has been isolated from a population of T-DNA-transformed plants. Genetic analysis revealed that the mutation is recessive and affects maternal seed tissues only. Due to the color of the immature seeds, this mutation was named banyuls (ban). Pigments accumulated continuously from early seed development to the desiccation stage in the seed coat of the mutant. The phenotype of the double mutant banyuls/ transparent testa confirmed the flavonoid nature of the pigments and enabled assignment of the regulatory TT (Transparent Testa) genes to two groups according to their epistatic relationship to ban. The flavonoid content of germinated ban and wild-type seedlings was similar. Plants harbouring the ban mutation had a normal formation of trichomes and root hairs and were not affected in their responses to light. The seeds of ban plants exhibited reduced germination compared to wild-type which may be a direct consequence of the high level of pigments. These results suggest that BANYULS functions as a negative regulator of flavonoid biosynthesis that prevents accumulation of pigments in the seed coat during early embryogenesis in Arabidopsis.

Infrared Transitions of H12C14N and H12C15N between 500 and 10 000 cm-1

We have measured the Fourier transform spectrum (FTS) of two isotopomers of hydrogen cyanide (H12C14N and H12C15N) from 500 to 10 000 cm-1. The infrared data have been combined with earlier published microwave and submillimeter-wave measurements. From this analysis new vibration-rotation energy levels and constants are given, based on the observation of a number of new vibrational levels, especially for H12C15N. The Coriolis interaction involving Deltav3 = -1, Deltav2 = 3, and Deltal = &plusmn;1 has been observed for a great many levels and in some cases the assignments of laser transitions allowed by this interaction are more clearly shown. New vibration-rotation constants are given that allow one to predict the transition wavenumbers for most of the transitions below 10 000 cm-1 with accuracies of about 0.5 cm-1 or better. Values are given for the power series expansion of the l-type resonance constants and for the centrifugal distortion constants, as well as the usual vibrational and rotational constants.

Induction and expression of seed-specific promoters in Arabidopsis embryo-defective mutants

In order to assess the importance of morphogenesis on the induction of promoter markers for storage and Lea programmes, advantage was taken of the emb mutations producing embryos arrested at a wide range of developmental stages in Arabidopsis. These embryos are viable during their stage of developmental arrest and continue to divide further, but apparently without further differentiation into the main organs and tissues of the normal embryos. Eight independent emb mutants arrested in their development prior to the cotyledon stage were selected. These emb embryos lack the normal morphology of the wild-type embryos when the synthesis of storage and Lea proteins are normally initiated. The 2S1-uidA chimeric gene, representative of the maturation programme and the Em 1-uidA chimeric gene, representative of the desiccation programme were introduced by crosses into the emb background. In the eight emb lines, the expression of the GUS reporter gene directed by the 2S1 and Em 1 promoters was observed in the aborted seeds irrespective of their stage of developmental arrest. The time of induction of the expression of both promoters was the same in the arrested embryos as compared with the normal embryos within the same silique. Thus, the activation of these two promoters is triggered by the same signal and can occur in the absence of morphogenesis. However, in the absence of normal organ formation, the expression of the reporter gene under the control of the 2S1 and Em1 promoters was evident throughout the whole seed tissues. In normal seed development, the hormone abscisic acid (ABA) activates the promoters of the 2S1 and Em 1 genes. One of the important members of the signal transduction pathway of ABA is the ABI3 protein. It has been shown previously that this protein is a prerequisite for the induction of Em 1 by ABA in seeds. A good correlation with the expression of the ABI3 promoter and the 2S1 and Em 1 promoters was found in emb seeds tissues. This observation suggests that the promoters of the 2S1 and the Em 1 genes are expressed in the mutant seeds not at a basal level, but are probably induced by ABA, as in normal seed development.

Molecular and genetic analysis of the Drosophila mas-1 (mannosidase-1) gene which encodes a glycoprotein processing alpha 1,2-mannosidase

Glycosylation is an important mechanism for modulating the physicochemical and biological properties of proteins in a stage- and tissue-specific manner. The enzymology of this process is just beginning to be understood. Here we present the molecular analysis of mas-1 (mannosidase-1), a Drosophila gene with significant homologies to mammalian and Saccharomyces cerevisiae glycoprotein processing alpha 1,2-mannosidases. An enhancer-trap P-element inserted upstream of mas-1 leads to highly specific lacZ expression in the lobula plate giant neurons, cells that mediate the large-field optomotor response. This staining, however, seems to reflect only a small part of the complex expression pattern of the mas-1 gene: Two promoters produce alternative transcripts that show individual spatial distributions during embryonic development, including a maternal contribution. Both transcripts code for type II transmembrane proteins which differ in their N-terminal parts. Null mutants in mas-1 display defects in the embryonic PNS, in the wing, and in the adult eye. These findings illustrate that the processing of N-linked glycans plays a functional role in Drosophila development. There is, however, ample evidence for genetic and biochemical redundancy in the mannose-trimming steps of this pathway.

Production and purification of Japanese quail ovalbumin as fusion protein with glutathione S-transferase in Escherichia coli

A plasmid encoding a fusion protein interlinked by thrombin recognition sequence between glutathione S-transferase and Japanese quail ovalbumin (without 40 amino acid residues from the 5'-end of the ORF) has been constructed, employing the expression system pGEX-2T. The deglycosylated fusion protein (64 kDa) was purified by affinity chromatography on glutathione agarose beads, analyzed by SDS-polyacrylamide gel electrophoresis, immunochemically detected with antiserum raised against Japanese quail ovalbumin and tested for its stability.

[Postmortem diagnosis of tropical malaria]

Thirteen days after returning from a four week holiday in Kenya a 35-year-old man consulted his doctor complaining of feeling unwell. The doctor diagnosed influenza and gave him a sickness certificate for three days. Because the patient did not reappear at his workplace a search was made and he was found dead in his flat seven days after seeing his doctor. A medicolegal autopsy was performed two days after the estimated time of death. There was marked swelling of liver and spleen together with jaundice and "dirty grey" colouration of the viscera. Samples of heart blood and spleen puncture material were taken. Giemsa stained preparations (ordinary and thick blood smears) revealed numerous objects 1.2 to 1.5 microns in size with indistinct reddish blue staining, some of them arranged in rosettes reminiscent of schizonts. A few of them contained pigment. In material from the spleen there were masses of blackish-brown pigment. The malaria immunofluorescence test performed on serum gave a weakly positive titre of 1:40. The findings were considered enough to support a diagnosis of fulminant falciparum malaria, and this was confirmed by histological changes in various organs, notably the typical capillary blockages in the brain. Because of the popularity of long-haul tourism, cases of imported malaria are increasingly frequent and, in view of the insidiously progressive course of the disease, it should always be considered in the differential diagnosis. In cases of unexplained death, if there is any suspicion of malaria, blood should always be taken for appropriate investigations, in addition to blocks for histological examination.

Purification and characterization of human ribonuclease HII

A ribonuclease H activity from human placenta has been separated by ion exchange chromatography from the major RNase HI enzyme. Additional chromatographic steps allowed further purification, more than 3,000 fold compared to the crude extract in which it represents about 15% of the total RNase H activity. The enzyme requires Mg2+ ions for its activity, is strongly inhibited by the addition of Mn2+ ions or other divalent transition metal ions, and exhibits a pH optimum between 8.5 and 9. It shows a strong sensitivity to the SH-blocking agent N-ethylmaleimide. It has a strict specificity for double-stranded RNA-DNA duplexes and exhibits neither single-stranded nor double-stranded RNase (or DNase) activities. Therefore, this enzyme displays the characteristics of class II RNase H and is now termed RNase HII. Renaturation gel assays and gel filtration experiments proved a monomeric structure for the active enzyme with a native molecular weight of about 33 kDa. The human RNase HII acts as an endonuclease and releases oligoribonucleotides with 3'-OH and 5'-phosphate ends. It is therefore a candidate for the RNase H-mediated effect of antisense oligodeoxynucleotides.

Molecular analysis of the helper T cell response in murine interstitial nephritis. T cells recognizing an immunodominant epitope use multiple T cell receptor V beta genes with similarities across CDR3

Anti-tubular basement membrane disease (alpha TBM disease) produces T cell-mediated interstitial nephritis in SJL mice after immunization with renal tubular antigen. Initial mononuclear infiltrates appear in vivo after several weeks, with the subsequent progression to renal fibrosis and end stage renal disease over many months. We have analyzed the fine specificity of the autoreactive helper T cell repertoire in alpha TBM disease through the isolation and characterization of a panel of CD4+ Th1 clones harvested after 1-2 wk from animals immunized to produce disease. All clones capable of mediating alpha TBM disease are directed towards a 14-residue immunodominant epitope (STMSAEVPEAASEA) contained within the target antigen, 3M-1. Evaluation of the T cell receptor (TCR) V beta repertoire used by these autoreactive T cells reveals the use of several V beta genes, but with some preference for V beta 14. Sequencing across the putative CDR3 region of the TCR beta chains suggests that common amino acids at the V beta(N)D beta junction and the D beta(N)J beta junction may contribute to the specific ability of these cells to recognize the immunodominant epitope.

Sensitive detection of low levels of ribonuclease H activity by an improved renaturation gel assay

Renaturation gel assays are good tools to assign enzymatic activities to protein bands. First, proteins are separated by denaturating electrophoresis on substrate-containing gels. Then, following the elimination of the denaturing agent, polypeptides are allowed to renature, thus leading to the degradation of the embedded substrate at positions at which the corresponding activity has moved. Nevertheless, this in situ technique does not only reflect a certain amount of enzyme activity, it also depends upon the ability of an enzyme to renature. Here we present a renaturation gel assay procedure with an improved sensitivity and discuss the detection of E. coli and human ribonuclease H activities as an example.

An invertebrate calcium-binding protein of the calbindin subfamily: protein structure, genomic organization, and expression pattern of the calbindin-32 gene of Drosophila

Antisera against vertebrate calcium-binding proteins cross-react with Drosophila nervous and muscle tissue. We have used an antiserum against carp parvalbumin to isolate from a Drosophila head cDNA library immunopositive expression clones. Tissue in situ hybridization identified a clone that labeled specific neurons and muscles similar to the parvalbumin-like immunohistochemical staining pattern. Five independent cDNAs derive from an mRNA whose open reading frame codes for a 310 amino acid polypeptide. Sequence analysis identifies six EF-hand calcium-binding domains and reveals 42% and 37% homology to chicken calretinin and calbindin D-28k, respectively. Since the positions of 9 out of 10 introns within the ORF are conserved from the Drosophila gene to both vertebrate genes, we conclude that we have identified the first invertebrate member of the calbindin sub-family of calcium-binding protein genes of the EF-hand homolog family. The calbindin-32 gene (cbn) maps to 53E on the second chromosome. It is expressed through most of ontogenesis with a selective distribution in the nervous system and in a few small adult thoracic muscles. The cloning of a Drosophila homolog to vertebrate neuronal Ca(2+)-binding proteins opens new routes to study the so far largely elusive function of these brain molecules.

Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine

Hyperkalemia is commonly encountered in patients who receive a renal transplant and the immunosuppressive drug, cyclosporine. There is also a high incidence of hypertension (which is thought to be due to expansion of the extracellular fluid volume) and hyperchloremic metabolic acidosis in this group of patients. This constellation of findings led to the suspicion of the possibility that their basis might be type II hypoaldosteronism. To test this hypothesis, 12 patients with hyperkalemia (plasma K+, 5.1 +/- 0.2 mmol/L at the time of study) while receiving cyclosporine were studied. Patients who had diabetes mellitus, those receiving drugs known to cause hyperkalemia (e.g., beta blockers, angiotensin-converting enzyme inhibitors, K(+)-sparing diuretics), or those with a serum creatinine greater than 200 mumol/L were excluded. The renal response to hyperkalemia was inappropriate because the transtubular K+ concentration gradient (TTKG) was only 4.3 +/- 0.4 compared with a TTKG of 13 +/- 1, 2 h after 50 mmol of KCl was given to normal subjects. The TTKG, after administration of 200 micrograms of fludrocortisone, was still very low (5.6 +/- 0.6) in the patients compared with that of controls (12 +/- 1). After administration of 250 to 500 mg of acetazolamide to increase the delivery of bicarbonate to the distal nephron, the TTKG rose significantly to 11 +/- 1 in patients on cyclosporine, compared with 17 +/- 1 in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Partial angle inversion recovery (PAIR) MR imaging: spin-echo and snapshot implementation

The effects of varying the inversion or excitation RF pulse flip angles on image contrast and imaging time have been investigated in IR imaging theoretically, with phantoms and with normal volunteers. Signal intensity in an IR pulse sequence as a function of excitation, inversion and refocusing pulse flip angles was calculated from the solution to the Bloch equations and was utilized to determine the contrast behavior of a lesion/liver model. Theoretical and experimental results were consistent with each other. With the TI chosen to suppress the fat signal, optimization of the excitation pulse flip angle results in an increase in lesion/liver contrast or allows reduction in imaging time which, in turn, can be traded for an increased number of averages. This, in normal volunteers, improved spleen/liver contrast-to-noise ratio (9.0 vs. 5.7, n = 8, p less than 0.01) and suppressed respiratory ghosts by 33% (p less than 0.01). Reducing or increasing the inversion pulse from 180 degrees results in shorter TI needed to null the signal from the tissue of interest. Although this decreases the contrast-to-noise ratio, it can substantially increase the number of sections which can be imaged per given TR in conventional IR imaging or during breathold in the snapshot IR (turboFLASH) technique. Thus, the optimization of RF pulses is useful in obtaining faster IR images, increasing the contrast and/or increasing the number of imaging planes.

Six enteropathogens isolated from a case of acute gastroenteritis

Isolation of six different gastrointestinal pathogens (Entamoeba histolytica, Plesiomonas shigelloides, Campylobacter jejuni and three different Salmonella species [Salmonella typhimurium, Salmonella blockley and Salmonella hadar]) in the feces of a German female tourist suffering from acute diarrhoea after a trip to Bali.

[Significance of cytomegalovirus in blood donation]

The subjects of the present study are diagnostic and epidemiologic aspects in the determination of serum antibodies to cytomegalovirus in blood donors, organ donors, dialysis patients and drug addicts (some of whom were HIV-positive); antibodies were determined using the ELA-Test (CMV-IgG ELA and CMV-IgM-ELA). 221 sera were additionally assayed using the CMV total AB EIA which has been used in the Frankfurt blood center since May 1985 for CMV antibody screening of blood donors: both enzyme immunoassays showed the same results in 214 sera (96.8%), which shows a high rate of correlation (requiv = 0.99, p less than 0.001). The groups were found to be CMV antibody positive as follows: blood donors 65/102 (63.7%), organ donors 10/13 (76.9%), dialysis patients 88/106 (83.0%), drug addicts 131/227 (57.7%), and HIV-antibody-positive drug addicts 17/31 (54.8%). There was a significant statistical difference between blood donors and dialysis patients (p less than 0.01); the difference between blood donors and drug addicts was also statistically significant when age was considered (p less than 0.001). There was no statistical significance in the distinction between HIV-negative and HIV-positive drug addicts. IgM-specific antibodies were found in 1/102 (0.98%) blood donors, 18/106 (17.0%) dialysis patients and 3/227 (1.3%) drug addicts, whereas in organ donors no IgM-specific antibodies were determined. The seropositivity rate of a Frankfurt group of regular blood donors (n = 1826) was 55.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Die Bedeutung des Zytomegalievirus im Biutspendewesen

Gegenstand der vorliegenden Arbeit sind diagnostische und epidemiologische Gesichtspunkte bei der Bestimmung von CMV-Antikörpern im Serum bei Blut- und Organspendern sowie Dialysepatienten und Drogenabhängigen (darunter ein Teil HIV-positiv) mittels Enzymimmunoassay (ElA). Der hierfür eingesetzte ELA-Test (CMV-IgG-ELA u. CMV-IgM-ELA) wurde mit dem «CMV total AB EIA», der seit Mai 1985 routinemäβig im Blutspendedienst Frankfurt/M. bei «Haustermin»-Blutspendern eingesetzt wird, verglichen: Bei 221 Seren zeigte sich in 214 Fallen (96,8%) übereinstimmende Ergebnisse, was einer hohen Korrelation entspricht (r_äquiv = 0,99, p < OOOl). Der CMV-Durchseuchungsgrad der einzelnen Kollektive war wie folgt: Blutspender 65/102 (63,7%), Organspender 10/13 (76,9%), Dialysepatienten 88/106 (83,0%), Drogenabhängige 131/227 (57,7%), HIV-AK-positive Dro-genabhängige 17/31 (54,8%). Der Unterschied zwischen Blutspendern und Dialysepatienten war statistisch signifikant (p<0,01), eben-so wie der Vergleich der Blutspender mit den Drogenabhängigen unter Berücksichtigung des «Alters» (p<0,001). Keinen signifikanten Unterschied ergab der Vergleich der HIV-AK-negativen mit den HIV-AK-positiven Drogenabhängigen. Bei der Untersuchung auf CMV-IgM-AK waren 1/102 (0,98%) Blutspender, 18/106 (17,0%) Dialysepatienten und 3/227 (1,3%) Drogenabhängige IgM-positiv, während Organspender kein CMV-IgM aufwiesen. Die CMV-Seropositivitätsrate des Frankfurter «Haustermin»-Blutspenderstammes (n = 1826) beträgt insgesamt 55,5%. Bei der Analyse im Hinblick auf CMV-Durchseuchung wurde – neben der Zugehörig-keit zu einer Risikospendergruppe – das Lebensalter als entscheiden-de Vorhersagevariable identifiziert: Jüngere Personen sind signifikant seltener CMV-infiziert als ältere (r= -0,71, p<0,001). Geschlechtsspezifische Effekte und die Zugehörigkeit zu einer bestimmten Blutgruppe (ABO-System) sind als Vorhersagevariablen zu vernachlässigen.

Cytomegalovirus infection of the alimentary canal: radiologic findings with pathologic correlation

A spectrum of radiologic findings in cytomegalovirus (CMV) infection of the alimentary canal seen in 14 patients and correlated with pathologic examinations is described. Twelve patients had acquired immunodeficiency syndrome and two had no identified immunosuppression. Autopsies were performed on 12. Diffuse CMV colitis was present in eight patients, enteritis in seven, esophagitis in four, gastritis in two, cholangitis in one, and acute pancreatitis in one. Of 11 patients with enteritis and/or colitis seven had significant lower gastrointestinal bleeding and five died as a result of it. Radiologic findings in the gastrointestinal tract included superficial or deep mucosal ulcerations, perforation or fistula formation, luminal narrowing, rigidity and thickening of the intestinal wall, and inflammatory infiltration of the mesentery. These were seen on barium examinations and computed tomographic (CT) scans. Findings of pancreatitis were seen on CT scans in one patient. In another, a cholangiogram showed abnormal bile ducts caused by CMV cholangitis. The radiologist should be aware of the diverse manifestations of the disease and its likely occurrence in immunosuppressed individuals.

Aminophylline toxicity

Aminophylline therapy has undergone change in the past decade. With the changes in usage and dosage forms, the frequency of toxicity in the pediatric population, especially in adolescents, has increased dramatically. Two distinct patterns, chronic and acute, have been recognized and treatment methods for both are changing. Table 4 summarizes the emerging state-of-the-art therapy for aminophylline toxicity. Judging from the activity seen in the literature, investigation into aminophylline toxicity will continue to be a priority. We will see a greater understanding of the disease process and a refining of the therapeutic process. The ultimate goal is the elimination of mortality and the minimization of morbidity from aminophylline toxicity.

Evidence for activated peripheral blood T-cells in rheumatoid arthritis

We have previously demonstrated defective antigen specific T-suppressor (Ts) cell function in the peripheral blood lymphocytes (PBL) from patients with rheumatoid arthritis (RA). Our study was designed to delineate whether diminished Ts activity is due to impaired interleukin (IL) dependent clonal expansion of Ts cells or to prior in vivo activation. Patients with recent onset of RA, or a disease flare, exhibited enhanced IL generation (IL-1 and /or IL-2). Increased proportions of active E-rosettes, elevated spontaneous production of IgM, and total immunoglobulin in mitogen free cultures were consistent with the concept of prior lymphocyte activation in vivo. Our results do not support defective clonal expansion of Ts cells as the basis of deficient IL generation, but do support the concept of in vivo activation of PBM cells in some patients with RA.

Methods of cancer case selection: implications for research

The race, age, and sex differences between clinically and microscopically diagnosed cancer cases for a total of 63,301 incident cases for 18 sites are reported. The cases, diagnosed during 1973-1978, were drawn from the Cancer Surveillance Section in the Division of Epidemiology at the Michigan Cancer Foundation in Detroit, a participant in the Surveillance, Epidemiology, and End Results (SEER) program. Although microscopically diagnosed cases and those diagnosed by other methods differed by race and sex for a few sites, the two case groups differed by age for 15 of the 18 sites examined. Cases without microscopic diagnoses (i.e., clinical diagnoses) tended to be older than microscopically confirmed cases. These findings indicate that in studies of certain cancer sites, the method of case selection could affect results pertaining to age differences in exposure to and effects of relevant risk factors.

Occupation and cancer of the lower urinary tract in Detroit

The relationship between occupation and cancer of the lower urinary tract in Detroit was examined by means of a population-based case-control study conducted as part of the National Bladder Cancer Study. Three hundred three white male patients with transitional or squamous cell carcinoma of the lower urinary tract and 296 white male controls selected from the general population of the study area were interviewed to obtain lifetime occupational histories. Our findings suggested that truck drivers have a significant increased risk of lower urinary tract cancer [relative risk = 2.1; 95% confidence interval (Cl) = 1.4-4.4]. A significant trend in risk was apparent with increasing duration of employment as a truck driver (P = 0.004); the relative risk estimated for truck drivers employed at least 10 years was 5.5 (Cl = 1.8-17.3). Truck drivers with a history of operating vehicles with diesel engines experienced a significant elevated risk compared to non-truck drivers (relative risk = 11.9; Cl = 2.3-61.1), but whether the increased risk observed among truck drivers was attributable to diesel exposure could not be evaluated. Nonsignificant excess risks were also seen for tool and die makers as well as for workers in several other industries and occupations. Employment in the motor vehicle manufacturing industry was associated with no significant excess risk of lower urinary tract cancer (relative risk = 1.1; Cl = 0.8-1.5).

Effect of the dynamic response of transducer-tubing system on accuracy of direct blood pressure measurement in patients

The dynamic responses of 3 transducer-tubing systems (TTS) were documented using square and sine wave generators. The TTS tested were P23 ID with 5 feet tubing (P23-5'), P23 ID with 6 inches tubing (P23-6") and P50A transducer with no tubing (P50). Natural frequencies were 45, 33, and 7 Hz for P50, P23-6", and P23-5', respectively. All were underdamped (damping coefficients 0.1-0.3). Simultaneous measurements of blood pressures by the 3 TTS revealed that systolic pressures recorded by P23-5' were significantly higher (p less than 0.001) than by P23-6" (17%) and P50 (16%). This difference was not influenced by the size of the arterial cannula or by the heart rate. However, the differences were greater with radial, compared to brachial arterial cannulation (p less than 0.02). There were no differences in systolic pressures measured with P23-6" and P50. There were no differences in diastolic or electronic mean pressures recorded by the 3 TTS.

Race, age and cancer incidence: a test of double jeopardy

One form of the double jeopardy hypothesis states that health declines more dramatically with age for blacks than it does for whites. This paper tests the hypothesis for black and white differences by age in cancer incidence rates. Age-specific incidence rates for 14 major cancer sites were compared in black and white, male and female populations in Detroit. Rates were based on 57,275 invasive cancer cases, diagnosed between 1973 and 1978, and drawn from the Michigan Cancer Foundation Registry, a member of the National Cancer Institute's Surveillance, Epidemiology, and End Results program. For men, differences between blacks and whites for most sites dissipate with age, reflecting a leveling trend. For women, there is no consistent trend for most sites. Double jeopardy is reflected in rates for cervical cancer. Public health programs should be targeted to elderly black women for cervical cancer screening and to middle-aged black men for multiphasic cancer prevention services.

Current surgical management of in situ cancer of the female breast

Surgical procedures for breast cancer were compared in 468 cases with in-situ and 4,967 cases with invasive lesions. The cases were obtained from the Michigan Cancer Foundation Registry, a Surveillance, Epidemiology, and End Results (SEER) participant, and were incident-resident cases diagnosed from 1973-1978. For single, primary in situ or invasive cancer, the preferred mastectomy was modified radical. Partial and simple resections were used more often than radical procedures for non-infiltrating, especially lobular lesions. For cases with bilateral primates, with at least one in situ, the mastectomy of choice was the simple procedure for the in situ malignancy and modified radical for the invasive cancer. The change in preferred surgery for in situ lesions, from modified radical to simple mastectomy, was not due to any change in strategy for treatment of bilateral invasive disease, which remained modified radical resection.

Breast parenchymal patterns: analysis of 332 incident breast carcinomas

A detailed analysis of 332 incident breast carcinomas is presented. The study results indicate that there is validity to the breast parenchymal patterns as an indication of risk for developing breast cancer and that risk is independent of length of follow-up and age of patient. All cases were drawn from a referral-type practice at Hutzel Hospital, Detroit, MI. The cases were compared to controls for computation of relative risk up to and beyond a follow-up period of 48 months. They were also compared to a consecutive series of prevalent breast carcinomas seen at Hutzel Hospital during the 6 years 1975-1980. The extent of disease in the cases described in this report is somewhat more favorable than in a consecutive series of prevalent cancers operated on a Hutzel Hospital. Most breast cancers occur in the P2 breast, a smaller number in the DY, and only 12% in the combined N1P1 type. The conclusions of other investigators regarding parenchymal patterns as risk indicators are reviewed. Particular attention was paid to comparing the length of follow-up and age of patient. There was no diminution of proportions of cases in the P2/N1-P1 or DY/N1-P1 after a 48 month follow-up. There was a significant diminution in the proportion of cases falling into DY/N1-P1 after age 50, and less so in P2/N1-P1. Furthermore, relative risk was unaffected by time or age.

Familial influences on breast parenchymal patterns

Some studies accomplished thus far have indicated that mammographic patterns may serve as risk indices for breast cancer. The present investigation was undertaken to determine whether patterns are familial. Mammograms from 110 mothers and their daughters and 122 sister pairs and a like number of unrelated controls matched for patient age, reproductive history, and personal and family history of breast cancer and drawn from the files of the Radiology Department of Hutzel Hospital, Detroit, Michigan, were compared. A familial influence was indicated by the finding that pattern similarities were significantly stronger in test cases than in unrelated controls. This influence appeared to be manifested by premature age changes in daughters and younger sisters and consisted, primarily, of a decrease in DY and an increase in P2 patterns. The data suggest that performing mammography on first degree relatives of women with high risk P2 and DY patterns should be considered.

Faking psychosis on the Rorschach: can expert judges detect malingering?

The susceptibility of the Rorschach to faking of psychological disturbance has been subject to few studies, all of which have significant methodological deficiences. Faking of psychosis was examined in this study by using Rorschach experts as judges to blindly evaluate both faked and actual psychotic protocols. The faked protocols came from role-informed and role-uninformed individuals who were asked to specifically malinger paranoid schizophrenia on the Rorschach. The results indicated that the expert judges were unable to detect the faked psychotic protocols regardless of whether the faker was or was not role-informed. However, significantly more role-informed faked protocols received psychotic designations than both the role-uninformed faked and actual psychotic protocols. Expert clinical judgments o- the Rorschach are apparently very susceptible to faking of serious disturbance.

Noncancer deaths in cancer and noncancer lineages

Starting with white probands who were potential milk donors in a program of human milk collection, a series of 2411 family health histories were obtained of the first degree relatives of the probands' parents. A lineage is defined as the parents and siblings of a parent of the proband as well as the parent. 2090 cancers were identified in the 31,939 people. Of the 21,712 persons without cancer in the parents' generation, age-specific death rates were significantly higher in those lineages with at least one cancer. This was true in infants, children and adults for both males and females (p less than 0.001). Cancer may be linked to other morbid conditions by a commonality of heredity, family environment, or perhaps both as necessary antecedents--neither sufficient by itself.

Familial cancer in the general population

In the course of collecting samples of human milk for the National Cancer Institute, family histories have been assembled since 1971. Ages, causes of death, reproductive histories, and the history and age of occurrence of cancer were obtained for all first degree relatives of the proband's parents. Two thousand and ninety cancers were identified in 31,945 persons. Cancers were confirmed by pathology reports, hospitals' and doctors' records, or death certificates. Of the family lineages, 65.9% had no cancers and 8.0% had two or more. For all cancers taken together, clustering was not significant but there was significantly more observed than expected cancers in lineages with cancer of breast, ovary, skin, corpus uteri, stomach, rectum, lung and bronchus, or colon. Little or no excess was observed in lineages with leukemia, lymphoma, and cancer of the cervix or prostate. The relative risk of breast cancer was increased 1.5 times for daughters and 3.8 times for sisters of women with the disease.

Adjunct hospital emergency toxicology service. A model for a metropolitan area

A feasibility demonstration with a gas chromatograph/mass spectrometer/computer system (GC/MS) was initiated to provide a 24-hour (seven days/week) adjunct emergency toxicology service to the hospitals in the tricounty area comprising Metropolitan Detroit. During June 1, 1974, to April 1, 1975, more than 85 different drugs and other agents were identified in the body fluids of approximately 1,000 victims of accidental or deliberate poisonings. At least one toxic substance was identified in 57% of the cases, and the presence of two or more drugs was established in one of five (19%) of the victims. This study indicates that a centrally located GC/MS/computer system can provide an effective adjunct emergency toxicology service for an entire metropolitan community and thereby provide guidelines for a prompt and rational therapy.