Histopathology of fetal diastrophic dysplasia

We report on three cases of diastrophic dysplasia in second trimester fetuses and discuss the differential diagnosis and clinical, radiologic, and histopathologic findings. Manifestations of typical diastrophic dysplasia in infants and older patients include abnormal pinnae, scoliosis, and joint contractures; these were absent in the fetuses, in keeping with the tendency for the clinical and radiologic aspects of this disease to become more severe with age. The histopathologic characteristics of the cartilage appear to be similar in the fetus and older patient, and therefore may be useful in differentiating diastrophic dysplasia from other osteochondrodysplasias in the second trimester.

Morphogenesis, biomass and oxytetracycline production of Streptomyces rimosus in submerged cultivation

The minimal concentration of adenosine triphosphate (ATP) which could be detected with spectrophotometry, HPLC and luciferin-luciferase methods was 1.0 microM, 3.3 microM and 100 nM, respectively. In submerged cultivation, most Streptomyces rimosus TM-55 was in hyphae fragment form at 65 h, became short-rod mycelia at 166 h, and lysed at 504 h incubation. The ATP content had maximal value at 24 h, then gradually decreased during cultivation. The oxytetracycline potency increased as incubation occurred, had maximal potency 178.9 micrograms/ml at 166 h, and then gradually decreased. Morphogenesis was very important in oxytetracycline production in submerged cultivation of Streptomyces; short-rod mycelia had high oxytetracycline production.

Portal blood flow in acute hepatitis with and without ascites: a non-invasive measurement using an ultrasonic Doppler

To evaluate the role of portal blood flow in severe acute hepatitis leading to the formation of ascites, we studied the portal blood flow of 30 patients with severe acute hepatitis (20 without ascites and 10 with ascites), 20 patients with mild acute hepatitis and 20 healthy normal volunteers using duplex sonography. The portal blood flow of patients with severe acute hepatitis and ascites (421 +/- 94 mL/min) was lower than that of the volunteers (725 +/- 131 mL/min), the mild acute hepatitis (658 +/- 148 mL/min), and the severe acute hepatitis (633 +/- 108mL/min) without ascites (P < 0.001). The congestion index of severe acute hepatitis and ascites (0.16 +/- 0.04 cm.s) was higher than that of the volunteers (0.09 +/- 0.03 cm.s, P < 0.001), the mild acute hepatitis (0.09 +/- 0.02 cm.s, P < 0.001), and the severe acute hepatitis (0.12 +/- 0.04 cm.s, P < 0.02) without ascites. Portal blood flow was negatively correlated with prolonged prothrombin time (P < 0.001) and serum total bilirubin level (P = 0.002) and congestion index was positively correlated with heart rate (P = 0.006), prolonged prothrombin time (P < 0.001) and serum total bilirubin level (P = 0.001). Our study shows that in severe acute hepatitis, portal blood flow was reduced in patients with ascites. The non-invasive ultrasonic Doppler is a safe and helpful method in the clinical evaluation of portal hypertension in severe acute hepatitis.

Polar [4+2(+)] diels-alder cycloaddition to nitrilium and immonium ions in the gas phase: Applications of multiple stage mass spectrometry in a pentaquadrupole instrument

Multiple stage MS(2) and MS(3) mass spectrometric experiments, performed using a pentaquadrupole instrument, are employed to explore the gas-phase ion-molecule chemistry of several nitrilium [R-C≡N(+)-H (1), R-C≡N(+)-CH3 (2), and H-C≡N(+)-C2H5 (3)] as well as immonium ions RR(1)C=N(+)R(2)R(3) (4) with the neutral diene isoprene. Polar [4+2(+)] Diels-Alder cycloaddition is observed for nitrilium ions when the energy gap between the lowest unoccupied molecular orbital (LUMO) of the ion and the highest occupied molecular orbital (HOMO) of the isoprene is small and the competing proton transfer reaction is endothermic. Thus, C-protonated methyl isonitrile H-C≡N(+)-CH3 (2a) and its higher homolog H-C≡N(+)-C2H5 (3a) form abundant [4+2(+)] cycloadducts with isoprene, but several protonated nitriles 1 do not; instead they show exothermic proton transfer as the main ion-molecule reaction. Replacement of the methyne hydrogen in 2a by a methyl, ethyl, or phenyl group (2b-d) raises the LUMO-HOMO gap, which greatly decreases the total yield of ion-molecule products and precludes cycloaddition. On the other hand, the electron-withdrawing acetyl and bromine substituents in 2e and 2f substantially lower the LUMO energy of the ions and cycloaddition reaction occurs readily. The simplest member of the immonium ion series, CH2=NH 2 (+) (4a), reacts readily by cycloaddition, whereas alkyl substitution on either the carbon or nitrogen (4b-f) dramatically lowers the overall reactivity, which substantially decreases or even precludes cycloaddition. In strong contrast, the N-phenyl (4g) and N-acetyl (4h) ions and the N-vinyl-substituted immonium ion, N-protonated 2-aza-butadiene (4i), react extensively with isoprene, mainly by [4+2(+)] cycloaddition. However, the isomeric C-vinyl-substituted ion (4j) displays only modest reactivity in both the proton-transfer and the cycloaddition channels.Collision-induced dissociation (CID) of the cycloadducts performed by on-line MS(3) experiments demonstrates that they are covalently bound and supports their assignments as cycloaddition products. Retro Diels-Alder fragmentation is a major process for cycloadducts of both the immonium and the nitrilium ions, but other fragmentation processes also are observed. The cycloadduct of 4a with butadiene displays CID fragmentation identical to that of the authentic ion produced by protonation of 1,2,3,6-tetrahydropyridine, which thus strengthens the [4+2(+)] cycloaddition proposal. AM1 calculations also support the formation of the [4+2(+)] cycloadducts, which are shown in several cases to be much more stable than the products of simple addition, that is, the ring-open isomers.

Doppler echocardiography in normal functioning valve prostheses

Even though there has been some criticism regarding the Doppler evaluation in prosthetic valves because of inter-observer and intra-observer variability, among other factors, and Doppler study has a tendency to have falsely high gradients compared to invasive studies, especially mechanical aortic prostheses, Doppler evaluation can provide reliable hemodynamic information about valve function. This test may be particularly useful if used serially, when baseline values are known. Doppler measurement of gradient and valve area has an expected normal range that is specific for the prosthetic type, size, anatomical position, and chronological age. Clearly, a database involving these aspects is needed to provide a more accurate normal range. This study is intended to provide guidance for echocardiographers.

Prenatal screening for cardiac anomalies: the value of routine addition of the aortic root to the four-chamber view

OBJECTIVE

To determine whether the addition of the aortic-root view would detect more congenital cardiac anomalies than a standard four-chamber view alone.

METHODS

The study included fetuses of 14 weeks' gestation or more who were scanned in our unit during a 28-month period. Outcome information was obtained from postnatal echocardiograms and autopsies. Abnormal hearts were classified as to whether the four-chamber or aortic-root view was abnormal.

RESULTS

There were 5967 fetuses in whom a four-chamber view could be obtained. In 5111 of these, an aortic-root view could also be obtained. The four-chamber view detected 24 (47%) of the 51 fetuses with abnormal hearts. Adding the aortic-root view increased the sensitivity to 78%.

CONCLUSIONS

Visualization of the aortic root is a quick and easy means of evaluating the aortic outflow tract during routine scanning. Adding the aortic-root view to the standard four-chamber view will result in the detection of most cardiac anomalies prenatally.

Impact of screening blood donors for hepatitis C antibody on posttransfusion hepatitis: a prospective study with a second-generation anti-hepatitis C virus assay

BACKGROUND

Hepatitis C is the major cause of posttransfusion hepatitis. Blood components that are positive for antibody to hepatitis C virus (anti-HCV) can transmit posttransfusion hepatitis.

STUDY DESIGN AND METHODS

To investigate the effect on posttransfusion hepatitis of screening blood donors with a second-generation test for anti-HCV, 249 transfusion recipients who underwent cardiovascular surgery were prospectively followed. Six recipients who were positive for anti-HCV before transfusion and 51 subjects with incomplete follow-up were excluded from this study.

RESULTS

Eleven (13.8%) of 80 subjects who received unscreened blood had two successive serum alanine aminotransferase levels > 90 U per L. Seven (8.8% of total) developed anti-HCV and HCV RNA and two (2.5% of total) developed IgM antibody to cytomegalovirus (IgM anti-CMV). By contrast, 3 (2.7%) of the 112 subjects who received anti-HCV-screened blood had two successive serum alanine aminotransferase levels > 90 U per L. None of these three developed anti-HCV and HCV RNA, but two (1.8% of total) showed the development of IgM anti-CMV. The study shows that screening for anti-HCV in blood donors with a second-generation test almost abrogated posttransfusion viral hepatitis C.

CONCLUSION

After anti-HCV screening, other body fluid-transmitted viruses such as CMV may become important in posttransfusion hepatitis.

Determination of aldicarb, aldicarb sulfoxide and aldicarb sulfone in tobacco using high-performance liquid chromatography with dual post-column reaction and fluorescence detection

A screening method for the determination of aldicarb (AS) and its sulfoxide (ASX) and sulfone (ASN) metabolites in tobacco at low ppm levels is described. Tobacco samples are extracted using methanol with the aid of sonication at ambient conditions. The extract is filtered and then injected into a high-performance liquid chromatograph equipped with a dual post-column reaction system and a fluorescence detector. Chromatographic separation is performed on a C18 column with a mixture of methanol-acetonitrile-water containing 0.1% of triethanolamine as the mobile phase. Triethanolamine is added to improve peak shape of AS residues and to reduce the undesired interaction between residual silanols and interferences, mainly amino acids and other amines. The average recoveries for AS residues spiked in tobacco are higher than 95% for AS, 91% for ASN and 85% for ASX at levels of 0.5-10 ppm (w/w). The detection limit is 0.5 ppm for each of the target compounds.

Chronic elemental mercury intoxication: clinical and field studies in lampsocket manufacturers

Four workers chronically exposed to elemental mental mercury in a lampsocket manufacturing factory were studied. The clinical manifestations were severe in one, mild in another, and suspicious in the remaining two. Correlation between severity of clinical features and increased urinary mercury concentrations was found. The time weighted average mercury concentrations were 0.945 mg/m3 and 0.709 mg/m3 for two workers in one room and 0.225 mg/m3 in the other. After stopping exposure, the workers recovered spontaneously or with D-penicillamine treatment within six months. It is concluded that recovery from chronic elemental mercury intoxication may be complete when patients are removed early from the exposure environment. The hazard of mercury intoxication in recycling of waste substances is emphasised.

Cystic enlargement of the iliopsoas bursa causing venous obstruction as a complication of total hip arthroplasty. A case report

The authors report an unusual complication of total hip arthroplasty. A patient developed significant swelling and discomfort in the left lower extremity 4 1/2 years following a left total hip arthroplasty. Magnetic resonance imaging and venography demonstrated a large intrapelvic mass compressing the external iliac vein. An arthrogram revealed a cystic cavity consistent with an iliopsoas bursa in communication with the hip pseudocapsule. Two aspirations of the bursa led to resolution of the cystic enlargement and symptoms. An enlarged iliopsoas bursa should be considered in the differential diagnosis of hip pain or extremity swelling after total hip arthroplasty.

Subcortical somatosensory evoked potentials in patients with hepatic encephalopathy caused by severe acute hepatitis

We studied the median nerve stimulated somatosensory evoked potentials (SEP) of 23 patients with hepatic encephalopathy (HE) resulting from severe acute hepatitis and 22 healthy volunteers. Ten patients who improved and survived more than 60 days were classified as Group 1 and the remaining 13 patients who died shortly after the SEP studies were classified as Group 2. The mean N9-N13 interpeak latencies (IPL) were not different among control and two patient groups. The mean N13-N20 IPL of Group 2 was significantly prolonged when compared with normal controls (P < 0.001) and Group 1 (P < 0.001). Five of the six patients with abnormal N13-N20 IPL died of hepatic failure within 24 h after SEP testing. The occurrence of abnormal subcortical conduction together with cortical dysfunction suggested that brain damage in terminal hepatic encephalopathy was diffuse. The presentation of abnormal prolongation of N13-N20 IPL of SEP during the course of severe acute hepatitis indicated a poor prognosis. Peripheral somatosensory conduction is unaffected even in terminal HE.

Listeriosis of the placenta: clinicopathologic study of seven cases

OBJECTIVE

The purpose of our study was to evaluate the usefulness of placental examination in the diagnosis of prenatal listeriosis.

STUDY DESIGN

Over a 7-year period, 4597 placentas with clinical indications for examination were retrospectively studied for morphologic evidence of listeriosis. The microbiology laboratory file records of positive Listeria monocytogenes cultures were used to confirm the diagnosis. The clinical records were studied for manifestations of the infection both in the neonates and in the mothers.

RESULTS

Seven placentas were identified as having listeriosis. The presence of macroabscesses, as opposed to microabscesses, was the most characteristic finding in this study, and the silver impregnation method was more reliable in identification of the bacilli in the tissue sections than the tissue Gram stains.

CONCLUSIONS

Listeriosis could be diagnosed by placental examination alone, and this examination frequently strengthened the clinical diagnosis. When the infection was not suspected clinically, the examination helped us reach the correct diagnosis.

Prospective study of abdominal ultrasonography before laparoscopic cholecystectomy

To investigate the role of abdominal ultrasonography (US) in predicting possible difficulties during laparoscopic cholecystectomy, we performed preoperative US evaluation prospectively in 82 consecutive patients. We correlated our predictions of "easy" and "difficult" with difficulties experienced at operation in surgery. The binary outcomes were analyzed by taking both easy category of US and surgical operation as positive results and both difficult category as negative results. We obtained satisfactory sensitivity (93.8%), accuracy (81.4%), and positive predictive value (84.7%), but low specificity (35.3%) and negative predictive value (60%). The highly positive results were the result of careful US examination. The low specificity and negative predictive value were attributed to the fact that most surgically difficult cases were due to adhesions around the gallbladder, difficult indeed to detect at US. We conclude that thorough abdominal US examination before laparoscopic cholecystectomy is useful in preoperative evaluation of patients undergoing laparoscopic cholecystectomy, even if it not infrequently fails to predict the surgically difficult cases mainly due to adhesions around the gallbladder.

Strategy and implementation of a system for protein engineering

This paper describes an overall view of an industrial protein engineering project from conception to successful completion. The choice of rational design was determined by the availability of an excellent three-dimensional crystal structure and the availability of information in the literature to define a strategy. The design strategy was refined extensively during the course of the project. The development of methods for mutagenesis, expression, verification, purification, and characterization of mutant enzymes is dictated in part by the enzyme property one chooses to modify and must be rapid yet accurate. Such an approach would be applicable to improve the stability of any other protein or enzyme. Using this approach, we successfully increased the stability of subtilisin BL over 10-fold at 50 degrees C with an overall success rate greater than 60%.

Skeletal histopathology in fetuses with chondroectodermal dysplasia (Ellis-van Creveld syndrome)

Chondroectodermal dysplasia (CED) is an uncommon autosomal recessive disorder and one of the short rib polydactyly syndromes (SRPS). It is characterized by acromelic and mesomelic shortness of limbs, postaxial polydactyly, small chest, ectodermal dysplasia, and in many cases, congenital heart defects. Controversy exists over possible changes in the growth plate. With the advent of ultrasonographic examination, increasing numbers of fetuses with osteochondrodysplasias are examined by pathologists. Since histopathologic examination of the skeletal system is useful in defining various osteochondrodysplasias and it has not been described in the fetus with CED, we herein describe 3 cases of fetal CED with emphasis on skeletal histopathology. All 3 pregnancies were terminated at 22-23 weeks because of ultrasonographic demonstration of short limbs and growth retardation. Radiologically, each fetus had acromelic and mesomelic shortness of long bones with smooth round metaphyses, vertically short iliac bones, short ribs and normal vertebrae. These findings are similar to those described in the larger newborn infant with CED. Histopathologically, the cartilage of the long bones showed chondrocytic disorganization in the physeal growth zone. The findings are dissimilar to those of larger infants and older children in whom chondrocytic columnization has been seen in the central physis and disorganization in peripheral physis. Furthermore, a variable degree of chondrocytic disorganization was also seen in the central physeal growth zone of vertebrae in these fetuses. Other findings noted at fetopsy were: polydactyly in all 3 cases, congenital heart defect in 2 and an abnormal frenulum in one case. The foregoing phenotypic and radiographic manifestations and skeletal histopathology help separate CED from other SRPS.

Valve-related events and valve-related mortality in 340 mitral valve repairs. A late phase follow-up study

To assess the early and late valve-related events, 340 consecutive patients undergoing mitral valve repair from 1969 to 1988 were evaluated. Follow-up was complete, with a mean of 7.5% years and range from 2 to 22 years (cumulative 2456 patient-years). There were 221 (65%) female patients. Rheumatic valvular disease was present in 246 (68%) patients. The remaining patients had ischemic or congenital valve disease, floppy valve or infective endocarditis. At surgery, 47% of the patients had pure mitral incompetence, 43% had mixed mitral stenosis and incompetence and 10% had predominant mitral stenosis. Seventy-three percent of the patients were in functional class III or IV. Twelve percent had had prior heart surgery. Concomitant valve procedures including coronary revascularization were performed in 62.3%. There were 23 hospital deaths (6.8%) but only 3 of these (0.8%) were valve-related in patients who died at reoperation for valve repair failure. There were 4 other early repair failures who survived early reoperation. Of the 317 hospital survivors, there were 127 late deaths, and an actuarial survival of 44 +/- 3.7% (70% CL) at 14 years. Of these, 13 were valve-related or 0.5% patient-year. Late events included thromboembolism (TE) 1% patient-year, anticoagulant bleeding 0.4% patient-year, infective endocarditis (IE) 0.2% patient-year and late reoperation for mitral valve repair failure in 63 patients or 2.8% patient-year. At the late follow-up, 88% of the hospital survivors were in functional class I or II.(ABSTRACT TRUNCATED AT 250 WORDS)

Protein enrichment of sweet potato residue with co-culture of amylolytic fungi by solid-state fermentation

Protein enrichment of sweet potato residue with amylolytic moulds by solid-state fermentation was higher than that obtained with amylolytic yeasts. The optimum initial moisture content for protein enrichment was 66% to 75%. Incrementally added nitrogen sources to the culture at zero time and at 24 h considerably improved the final protein content. During the cultivation, the moisture, ash and ATP contents increased, while the pH value decreased. A 1:1 co-culture of amylolytic mycelial fungi yielded a product with 32.4% crude protein after 4 days incubation at 30 degrees C.

Disappearance of N20 and P25 components of somatosensory evoked potential: an ominous sign in severe acute hepatitis

The scalp-recorded somatosensory evoked potentials (SSEPs) of 14 patients who died of hepatic encephalopathy (HE) caused by severe acute hepatitis and 22 normal volunteers were studied. The present data showed that progressive deterioration of HE resulted in sequential prolongation and eventual disappearance of SSEP components beginning from the late P90 component towards the early P25 and N20 components. Four patients with systemic hypotension, supposedly due to brain edema and increased intracranial pressure, showed disappearance of the N20 and P25 components and died within 24 hours. The N20 and P25 components were preserved in the other 10 patients without systemic hypotension. The disappearance of the N20 and P25 components as well as later components suggests an almost total loss of cortical function. The present study suggests that the disappearance of the N20 and P25 components during the course of HE is an ominous sign in severe acute hepatitis.

The crystal structure of the Bacillus lentus alkaline protease, subtilisin BL, at 1.4 A resolution

The crystal structure of subtilisin BL, an alkaline protease from Bacillus lentus with activity at pH 11, has been determined to 1.4 A resolution. The structure was solved by molecular replacement starting with the 2.1 A structure of subtilisin BPN' followed by molecular dynamics refinement using X-PLOR. A final crystallographic R-factor of 19% overall was obtained. The enzyme possesses stability at high pH, which is a result of the high pI of the protein. Almost all of the acidic side-chains are involved in some type of electrostatic interaction (ion pairs, calcium binding, etc.). Furthermore, three of seven tyrosine residues have potential partners for forming salt bridges. All of the potential partners are arginine with a pK around 12. Lysine would not function well in a salt bridge with tyrosine as it deprotonates at around the same pH as tyrosine ionizes. Stability at high pH is acquired in part from the pI of the protein, but also from the formation of salt bridges (which would affect the pI). The overall structure of the enzyme is very similar to other subtilisins and shows that the subtilisin fold is more highly conserved than would be expected from the differences in amino acid sequence. The amino acid side-chains in the hydrophobic core are not conserved, though the inter-residue interactions are. Finally, one third of the serine side-chains in the protein have multiple conformations. This presents an opportunity to correlate computer simulations with observed occupancies in the crystal structure.

Effect of moisture content on the microbial activity in JP-5 fuel oil

The water solubility of JP-5 fuel oil was found to be proportional to the reciprocal of absolute temperature from 0 degree C to 60 degrees C. Water in the fuel oil would become condensed once the temperature was shifted from a high temperature to low temperature. During the storage, condensed water was precipitated in the bottom of the tank. Both the static and the dynamic dehumidification processes with molecular sieve could reduce the moisture content of fuel oil to less than 5 ppm. However, pre-dried fuel oil had a mildly hydroscopic phenomenon at relatively high humidity condition. The spores of contaminated microbes could survive in the fuel oil with 5 to 80 ppm of moisture content. High moisture content of fuel oil was not favorable to the spore survival. Penicillium sp. could survive in the fuel oil longer than Cladosporium resinae.

Order and Low Dimensionality in the Organic Superconductor (BEDT-TTF)2Cu(NCS)2 Revealed by STM

Single-crystal samples of [(BEDT-TTF)(2)]+[Cu(NCS)(2)]-were synthesized and studied with a scanning tunneling microscope (STM). Real-space images of the anion and cation surfaces with molecular resolution were obtained. The images show no evidence of structural disorder or stacking faults previously suggested. The presence of an additional modulation commensurate with the lattice provides evidence of a lattice distortion. The cause of this modulation is unknown. The presence of a charge density wave in the material would have implications on the dimensionality of the material that may explain the peculiar temperature dependence of the electrical conductivity. This interpretation is consistent with the calculated Fermi surface, which allows nesting of the wave vector.

Baclofen intoxication: report of four cases and review of the literature

Four cases of baclofen intoxication are reported, with a review of 33 cases from the literature. Analysis of these 37 cases suggests that there are two types of baclofen intoxication syndrome. Patients with acute intoxication present with four major clinical manifestations: encephalopathy (disturbance of consciousness and/or seizure), respiratory depression, muscular hypotonia, and generalized hyporeflexia. Patients with chronic intoxication present with hallucinosis, impaired memory, catatonia, or acute mania. The acute intoxication syndrome has a faster onset, shorter duration, more severe clinical manifestations, and higher incidence of seizures than the chronic intoxication syndrome. Baclofen intoxication, although it may cause grave encephalopathic manifestations and electroencephalographic findings, has a benign outcome if actively managed.

Chemical analysis and amino acid content of temperature-sensitive mutants of Saccharomyces cerevisiae

Temperature-sensitive (ts) mutants of Saccharomyces cerevisiae Y-196 were isolated by using UV irradiation and/or EMS treatment. They grew normally at permissive temperature (30 degrees C), but could not grow at restrictive temperature (38 degrees C). From chemical composition analysis, it was found that ts mutants AMY-159, and AMY-88 had the highest protein and RNA contents, respectively. When the cells were cultivated at 30 degrees C to stationary phase and then shifted to 38 degrees C for 4 hr, protein contents of wild-type and most of the ts mutants increased but RNA contents decreased. Glutamic acid, aspartic acid and lysine were the three major amino acids of protein in all isolates tested at both temperatures. When the ts mutants AMY-136, AMY-161, and AMY-157 were cultured at 38 degrees C for 4 hr, methionine contents increased Amino acid scores of ts mutants AMY-15 and AMY-88 increased when they were shifted to 38 degrees C for 2 to 4 doubling times. The amounts of amino acids produced in some ts mutants were higher than that of wild-type.

[Idiopathic retroperitoneal fibrosis causing obstructive uropathy: a case report]

Idiopathic retroperitoneal fibrosis leading to obstructive uropathy is a rare disease in our country, so a typical case deserves presentation. The patient is a 56-year-old female to have a clinical manifestation of obstructive uropathy. Retrograde pyelogram permitted 5 Fr. ureteral catheter to pass the stenotic segment. At the mean-time, there was hydronephrosis, medial deviation and gradual thinning and pointing of the middle segment of the ureter (classic triad). Computed tomography revealed that retroperitoneal soft tissue plaque enveloped aorta, inferior vena cava, and bilateral ureters. The patient received ureterolysis with ureter intraperitonealization and lateralization. The plaque was pathologically proved fibrosis. Renal function became normal postoperatively.

Report of fourteen cases of nonimmune hydrops fetalis in association with hemorrhagic endovasculitis of the placenta

Hemorrhagic endovasculitis of the placenta is a distinct vasodestructive process of unknown cause that has been associated with perinatal morbidity and mortality. A relationship between nonimmune hydrops fetalis and hemorrhagic endovasculitis has not been previously described. At a large teaching hospital, six cases of nonimmune hydrops fetalis were identified out of 72 cases of hemorrhagic endovasculitis over 6 years, for an incidence of 8%. Conversely, these same six cases represented 24% of the 25 cases of nonimmune hydrops fetalis from this time period. Eight additional cases of nonimmune hydrops fetalis were found among 2064 cases of hemorrhagic endovasculitis at the Michigan Placental Tissue Registry. In eight of the total 14 cases, after congenital malformations and cytomegalovirus infections were excluded, hemorrhagic endovasculitis was the only significant associated pathologic finding evident. The significance of the relationship between nonimmune hydrops fetalis and the vascular abnormalities of hemorrhagic endovasculitis remains to be determined.

Short rib syndrome Beemer-Langer type with polydactyly: a multiple congenital anomalies syndrome

A male fetus with short rib (polydactyly) syndrome, Beemer-Langer type was aborted at 30 weeks' gestation because of abnormalities visualized on sonography. This is the first documented case with polydactyly in this recently defined entity. The clinical, radiological, and pathological findings, especially of the bones, are described. The differential diagnosis of this entity is discussed.

The effect of oral nitroglycerin on portal blood velocity as measured by ultrasonic Doppler. A double blind, placebo controlled study

We studied the effect of oral nitroglycerin on portal blood velocity (PBV) in 20 cirrhotic patients by a double blind, placebo controlled method using noninvasive Doppler sonography. After we obtained baseline Doppler in the fasting state, 0.6 mg nitroglycerin or placebo was given orally and the mean of 3 s averaged mean PBVs was repeated at 5 min intervals for 60 min. Ten patients each received nitroglycerin or placebo. Portal vein flows were antegrade in all. Of the 10 patients receiving nitroglycerin, seven (P = 0.002) showed a greater than 10% fall in the mean PBVs for at least 15 min. Of these seven "responders," five patients had a 10% decrease in mean systemic blood pressure for at least 15 min. None of the "nonresponders" had systemic hypotension. Our study suggests that the PBV-reducing effect of nitroglycerin in cirrhotics may be explained in part by systemic hypotension.

Oxytetracycline production in solid state and submerged fermentation by protoplast fusants of Streptomyces rimosus

Streptomyces rimosus TM-55 was treated with 3% EMS, and 29 auxotrophic mutants (AM-1 - AM-29) were isolated from 5457 colonies at a survival rate between 6.6-66.7%. Three sets of the auxotrophic mutants, AM-3 and AM-27, AM-7 and AM-28, and AM-3 and AM-21, were chosen for protoplast fusion with 50% PEG 1000 for 30 minutes at 25 degrees C, and 25 fusants were isolated (f-1 - f-25). In solid substrate, oxytetracycline production of 20% fusants was higher than that of the wild strain, while in submerged fermentation, it was 44%. Oxytetracycline productions of fusants f-1, f-6, f-11, f-12, f-20 and f-21 were lower than that of the wild strain in solid substrate, but this was reversed in submerged fermentation. On the other hand, OTC production of fusant f-8 was higher than that of the wild strain in solid substrate, and this was reversed in submerged fermentation.

ADAM sequence and innocent amniotic band: manifestations of early amnion rupture

Thirteen placentas with early amnion rupture (EAR) are described. These placentas were characterized by the absence of amniotic epithelium on the fetal surface, presence of a slightly fibrotic small amniotic band (remnant) attaching to the umbilical cord at the placental end, and the presence of degenerated vernix squamous cells in the fibrous stroma of chorion and amnion. Eight fetuses had ADAM sequence. Six of these fetuses were miscarried between 16 and 28 weeks of gestation. Two affected infants were born alive at gestational ages of 29 and 39 weeks. Five infants were spared by ADAM sequence; two had the umbilical cord strangulated by an amniotic band and were delivered at 27 and 37 weeks. In the 3 infants unassociated with ADAM sequence or strangulation of the umbilical cord, their placentas were interpreted as having innocent amniotic band (IAB) and they were delivered between 32 and 40 weeks. The findings in this study support Torpin's hypothesis that ADAM sequence is a complication of EAR. This ADAM sequence due to simple EAR must be separated from the limb body wall malformation complex because visceral anomalies are uncommon in the former condition but are frequently seen in the latter. In this study the placental pathology of EAR was helpful in confirming the ADAM sequence in the fetus.

A human hepatocellular carcinoma 3.0-kilobase DNA sequence transforms both rat liver cells and NIH3T3 fibroblasts and encodes a 52-kilodalton protein

Neoplastic transformation of rat liver cells in vitro by DNA-mediated gene transfer with an oncogene, hhcM, derived from human (Mahlavu) hepatocellular carcinoma, is described and compared with that of NIH3T3 cells. hhcM was cloned in a neomycin-resistant simian virus 40 promoter vector (pNeor/S) and was designated pNrpM-1. BRL-1 or NIH3T3 cells, transfected with pNrpM-1 DNA, showed significant morphological changes, loss of contact inhibition, and anchorage-independent growth. They became highly tumorigenic in nude rats and nu/nu mice. Control BRL-1 and NIH3T3 cells, whether transfected with pNeor/S DNA or not, remained contact inhibited and nontumorigenic. Both the transformants and the tumor cells contained integrated hhcM DNA as shown by Southern blot hybridization. The complete nucleotide sequence of the hhcM 3.0-kilobase DNA was also determined, and it consisted of a possible open reading frame for a protein of 52 kilodaltons (467 amino acids). The high-level production of a slightly modified form of this 52-kilodalton protein in a bacterial expression system has been successfully achieved. The bacteria-produced protein was similar in electrophoretic behavior to the 52- to 53-kilodalton protein synthesized in a cell-free translation system using rabbit reticulocyte lysate programmed with hybrid-selected hhcM-specific mRNA from Mahlavu hepatocellular carcinoma cells.

Isolation and characterization of temperature-sensitive mutants of Saccharomyces cerevisiae

Temperature-sensitive (ts) mutants of Saccharomyces cerevisiae Y-196 were isolated by UV irradiation and/by EMS treatment. There were 163 ts mutants isolated from 66,957 colonies. These mutants were designated as AMY-1 to AMY-163. These ts mutants grew normally at 30 degrees C, but did not grow at 38 degrees C. In an auxanographic study, we showed that AMY-46 was an absolute ts mutant, while AMY-10, AMY-15, AMY-16, AMY-49, AMY-66, AMY-88, AMY-114, AMY-126, AMY-127, AMY-129, AMY-136, AMY-150, AMY-157, AMY-158, AMY-159, AMY-161, and AMY-162 were auxotrophic ts mutants except AMY-16 had cell size 2-42% larger than that of the wild type. Cell aggregation phenomenon was found when the ts mutants were cultivated at 30 degrees C to stationary phase then cultured at 38 degrees C for 4 hr. The budding numbers at 30 degrees C were less than that at 38 degrees C. Mutant AMY-49 had the highest budding number. There was a positive correlation between the growth rate and the average budding number. However, there was a negative correlation between the growth rate at 30 degrees C and the length of long axis of cell or the size of cell.

Urachal remnants: sonographic demonstration in children

On 62 of 100 pediatric bladder sonograms a small, elliptical, hypoechoic structure was observed on the middle of the anterosuperior surface of the urinary bladder. One of the these structures was removed surgically, and pathologic examination disclosed a normal urachal remnant. Since it is a common sonographic finding in children, it should not be mistaken for a pathologic process unless it is accompanied by signs and symptoms of infection or bladder obstruction.

Protection of the immature myocardium during ischemic arrest: dose dependent effects of glucose and mannitol when added to St Thomas' cardioplegic solution

It has been suggested that immature hearts are less well protected by conventional cardioplegic solutions than are adult hearts. In an attempt to develop an improved cardioplegic solution for use in the immature ischemic heart the authors investigated whether the addition of various concentrations of glucose or mannitol to St Thomas' Hospital cardioplegic solution can improve its protective ability. Hearts from immature (three- to five-day-old) rats were perfused as Langendorff preparations with an indwelling left ventricular balloon. Contractile function (left ventricular developed pressure, maximum rate of development of pressure, heart rate, rate-pressure product and coronary flow) was recorded before and after a period of normothermic global ischemia with preischemic infusion (2 mins) of St Thomas' Hospital cardioplegic solution. In preliminary experiments the post ischemic recovery of contractile function was related to the duration of ischemia. With 60, 75, 90 and 120 mins of ischemia the post ischemic recovery of developed pressure was 47.6 +/- 3.9%, 17.4 +/- 5.5%, 15.0 +/- 5.4% and 13.8 +/- 4.8%, respectively, of its preischemic control. Comparable results were obtained with the other indices of cardiac function. The effect on the post ischemic recovery of function and tissue water content of the addition of mannitol or glucose (10, 20, 40, 60 or 80 mmol/L) to the cardioplegic solution was examined after 60 mins of ischemia. The mannitol groups tended to show consistently better recoveries at all concentrations studied but the improvement was small and rarely achieved a degree of statistical significance. In contrast glucose gave a U-shaped dose response profile with a significant deleterious effect at 10, 20 and 40 mmol/L.(ABSTRACT TRUNCATED AT 250 WORDS)

Cavernous lymphohemangioendothelioma of the right atrium--a case report

The authors report a successful resection of a rare cystic tumor in the right atrium, discovered in an asymptomatic patient with atrial fibrillation. The cystic nature of the tumor was characterized by two-dimensional echocardiogram preoperatively. The site of attachment and movement of the tumor were clearly shown by cine computed tomography preoperatively. The tumor contained numerous endothelium-lined cavernous channels and groups of red blood cells. These features are distinctly different from those of other cystic tumors.

Macromolecule synthesis in temperature-sensitive mutants of methanol-utilizing Hansenula polymorpha

Temperature sensitive (ts) mutants of methanol-utilizing Hansenula polymorpha NTU-AM-P5 were isolated by UV irradiation, EMS and/or NTG treatment. They grow normally at permissive temperature (PT) 38 degrees C, but can not grow at restrictive temperature (RT) 46 degrees C. From chemical composition analysis, it was found that ts mutants NTU-AM-L2 and NTU-AM-L3 had higher RNA content than the others; while ts mutant NTU-AM-E19 had the highest protein content among the isolated strains. Leucinyl-tRNA synthetases activity was the highest among the twenty aminoacyl-tRNA synthetases in both wild type and their ts mutants. When the cells were shifted from PT to RT for 12 h, total aminoacyl-tRNA synthetase activity decreased in all tested strains. Leucinyl-tRNA synthetase of ts mutant NTU-AM-E10 decreased 91.23%. At RT, it was found that ts mutants NTU-AM-E10 and NTU-AM-E20 were defective in DNA synthesis; ts mutants NTU-AM-E15, NTU-AM-E20, NTU-AM-N37 and NTU-AM-m5 were defective in RNA synthesis; ts mutants NTU-AM-E10, NTU-AM-E20 and NTU-AM-m5 were somewhat defective in protein synthesis; while ts mutants NTU-AM-L2 and NTU-AM-L3 did not belong to any one of the above classifications.

Digoxin-like immunoreactive substances in chronic liver disease

Digoxin-like immunoreactive substances, which cross-react with digoxin antibody, have been found to have natriuretic effect and Na+,K+-ATPase inhibitory effect. The role of digoxin-like immunoreactive substances in chronic liver disease was studied by radioimmunoassay in 63 serum and 60 urine samples from 58 patients with chronic liver disease and compared with 16 controls. Although the mean serum digoxin-like immunoreactive substances level of compensated chronic liver disease patients (0.06 +/- 0.05 ng per ml, p less than 0.01) was higher than that of controls (0.02 +/- 0.03 ng per ml), only four patients had serum digoxin-like immunoreactive substances higher than 0.10 ng per ml. Mean serum digoxin-like immunoreactive substances level was much higher in patients with decompensated chronic liver disease who had ascites (0.32 +/- 0.17 ng per ml, p less than 0.001), hepatorenal syndrome (0.57 +/- 0.20 ng per ml, p less than 0.001) and hepatic encephalopathy (0.43 +/- 0.20 ng per ml, p less than 0.001). Five patients with recent variceal hemorrhage requiring transfusions and saline infusion had significantly increased serum digoxin-like immunoreactive substances (mean: 0.16 +/- 0.06 ng per ml, p less than 0.001) before the development of clinically detectable ascites.(ABSTRACT TRUNCATED AT 250 WORDS)

Fibrinous pericarditis in alcoholic liver disease

The autopsy data at the University of Southern California Liver Unit was studied during a 6-year period to investigate the relationship of fibrinous pericarditis with liver diseases. We found 18 cases of fibrinous pericarditis in 220 patients with alcoholic liver disease but none in 32 patients with fulminant and subacute hepatitis without alcoholism or in 39 patients with nonalcoholic cirrhosis. Although all the 18 patients with pericarditis had azotemia, 3 patients had pericarditis develop only in mild renal function impairment. These findings suggest that chronic alcoholism may precipitate pericarditis during the hepatorenal syndrome.

Fixed spinal cord: diagnosis with MR imaging

Pulsatile motion of the spinal cord was examined with phase imaging techniques. Sagittal images of the spinal cord were obtained at different times of the cardiac cycle in healthy volunteers, as well as in patients in whom the spinal cord either was tethered, was compressed, or contained an intramedullary lesion. Pulsatile velocity changes of the spinal cord, observed on the phase images, were most marked at the cervical-upper thoracic level. Cord motion was found to be significantly decreased in cases in which the cord was either tethered or compressed. Cord enlargement due to an intramedullary lesion generally did not lead to decreased cord motion. Imaging of pulsatile cord motion may be clinically useful in evaluating diseases restricting cord motion or changing the status of parenchymal compliance.

Transforming DNA sequences of human hepatocellular carcinomas, their distribution and relationship with hepatitis B virus sequence in human hepatomas

Several related human transforming DNA sequences, hhc, and a putative normal liver homologue, c-hhc, have been molecularly cloned from the genomic DNAs of individual African and Asian hepatomas and from normal liver respectively. hhcM (Mahlavu) and hhcK3 (Korean), but not c-hhc, transformed NIH3T3 cells in DNA-mediated gene transfer assays. Transformed cells were found tumorigenic in athymic NIH Swiss nu/nu mice. In view of recent epidemiological studies implicating hepatitis B virus (HBV) infection early in life as causative for the eventual development of primary hepatocellular carcinoma in humans in Southeast Asia, the Far-East, and certain areas of Africa, we hereby analyzed the relationship between these hhcs and HBV in a survey of 20 hepatomas for DNA sequences homologous to hhcM and HBV by sequential hybridizations against [32p]hhcM and [32p]HBV probes. hhcM related DNA sequence were found highly amplified in 80% of the 20 hepatomas but HBV DNA sequence was rare or low. hhcM lends itself as a marker for human hepatomas. However, overall results indicated that patients with integrated HBV DNA sequences showed high copy number of hhcM sequence. Furthermore, EcoR1-restricted hepatoma DNAs showed that HBV and hhcM DNA sequences resided at different fragments in hepatomas. Our results suggest that HBV contributes to hepatocarcinogenesis probably via an activation mechanism involving possibly an integration or transient interaction of HBV DNA with hepatocyte DNA sequences, leading to recombination and eventual amplifications of the hhcM sequence in Mahlavu.

Induction of B-cell lymphomas in athymic NIH Swiss nu/nu mice

A B-cell lymphoma was induced in athymic NIH Swiss nu/nu mice by challenging the animals with NIH3T3 cells, previously transfected with a recombinant DNA carrying a human oncogene hhcM, ligated to an SV40 promoter with a neomycin-resistance marker. The gross pathology of the tumor-bearing animal revealed generalized lymphadenopathy and the histopathology indicated widespread infiltration of lymphocytes into organs, such as brain, liver, kidney and lung, in addition to the lymphoid tissues and spleen; the appearance was consistent with diffuse histiocytic lymphoma. Direct immunofluorescence assays with specific typing anti-sera on live cells prepared from spleen and various lymph nodes in short-term culture, suggested the cells were B-cells. This B-cell lymphoma provides an experimental model, not only for studying possible oncogene activation but also for studying the various interactions involved in signal transduction essential for the activation of B-cell proliferation and differentiation.

Analysis of cough/cold products using an adamantyl column

High-performance liquid chromatographic methods are developed for the determination of active ingredients in several cough/cold preparations. A novel adamantyl phase is used in combination with either totally aqueous or high aqueous hydroorganic mobile phases.

A recent review of secondary mobile phase modifiers used to enhance the chromatographic analysis of pharmaceuticals

A review that surveys recent work on the use of secondary mobile phase modifiers in the chromatographic analysis of pharmaceuticals is presented. The most commonly used reagents are alkylammonium salts, alkylsulfonates, alkylsulfates, and alkylamines.

Reperfusion-induced arrhythmias: characterization studies with the globally ischemic rat heart

It has previously been demonstrated in the rat heart, in vivo and in vitro, with regional ischemia, that an asymmetric bell-shaped curve defines the relationship between the vulnerability to reperfusion-induced arrhythmias and the duration of the preceding period of ischemia. The present study sought to establish whether a similar relationship occurred with global ischemia and reperfusion. Using rats from three different sources (two British, one North American) it was observed that, when an appropriate duration of ischemia was selected, reperfusion was capable of eliciting a very high incidence (up to 100%) of ventricular fibrillation and ventricular tachycardia. In the first series of studies an asymmetric bell-shaped relationship was observed such that with reperfusion after 5, 10, 20, 25, 28, 30, 33, 37 and 45 mins 0, 8, 8, 8, 50, 58, 83, 33, 33 and 25% of hearts fibrillated, respectively (12 hearts per group). However, upon repeating the studies with groups of rats from other suppliers or different batches from the same supplier, different results were obtained. Thus, in some study groups a very high incidence of arrhythmia was observed with reperfusion after very short (7.5 mins) durations of ischemia and low incidences were sometimes obtained with reperfusion after 30 mins, a time which, in some study groups, elicited a very high (100%) incidence of severe arrhythmias. These results contrast strikingly with those obtained with regional ischemia where a highly reproducible profile for the incidence of arrhythmias is consistently observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Portal-systemic encephalopathy: alterations in somatosensory and brainstem auditory evoked potentials

Median somatosensory and brainstem auditory evoked potentials (SEP and BAEP) were studied in 40 patients with liver cirrhosis consequent to chronic viral hepatitis. The patients were divided into 4 groups: group 1 with liver cirrhosis only, group 2 with hepatic failure (HF), group 3 with grade 1 or 2 hepatic encephalopathy (HE), and group 4 with grade 3 or 4 HE. The control group consisted of 10 age-matched normal subjects. The major changes occurred in the median cortical SEP late components (peaks after N20 and P25). From group 1 to group 4, there were progressive prolongation and sequential disappearance of the late components. Those changes in the cortical SEPs were reversible. The subcortical somatosensory and brainstem auditory conductions (SEP N13-N20 and BAEP I-V interpeak latencies) were slightly prolonged in all groups of patients. The present data indicate that SEP may be useful in detecting subclinical HE and in monitoring the clinical course of HE. The present data further indicate that chronic portal-systemic shunting in liver cirrhosis may result in a minimal impairment of cerebral function and sensory conduction in the CNS.

Isolation and characterization of temperature-sensitive mutants of Hansenula

For investigation of the feasibility of obtaining yeast strains with high protein and low nucleic acid content or high nucleic acid and low protein content for industrial production of single cell protein or nucleotide, the methanol-utilizing Hansenula polymorpha NTU-AM-P5 was chosen for isolation of temperature-sensitive mutants. Approximately 70 temperature-sensitive (ts) mutants were obtained. All of the ts mutants increased in cell size and aggregated when they were cultivated at permissive temperature and shifted to restrictive temperature in the late log phase or in the stationary phase. 86.1% of ts mutants had a lower growth rate than that of their wild-type. Only ts mutants, NTU-AM-L2, NTU-AM-E10, NTU-AM-E19, NTU-AM-E25 and NTU-AM-E30 had same or slightly higher than that of their wild-type strain. Cycloheximide at 1 mg/ml inhibited the growth of ts mutant NTU-AM-E19, but inhibited one-third of the other ts mutants, and their wild-type strain. Rifampicin at 0.1 mg/ml had an inhibitory activity on wild-type strain but not on ts mutant NTU-AM-E1. ts mutants NTU-AM-L2 and NTU-AM-E19 converted methanol to cell mass more efficiently than others. The ts mutants divided into two groups. One included absolute ts mutants, such as NTU-AM-E15 and NTU-AM-E20, which did not grow even in enriched media at restrictive temperature; the other group, such as NTU-AM-L2, NTU-AM-L3, NTU-AM-E10, NTU-AM-E19, NTU-AM-N37 and NTU-AM-m5, was auxotrophic ts mutants, which grew slightly in enriched media at restrictive temperature.