Implants of polymer-encapsulated human NGF-secreting cells in the nonhuman primate: rescue and sprouting of degenerating cholinergic basal forebrain neurons

Baby hamster kidney (BHK) cells were genetically modified to secrete high levels of human nerve growth factor (BHK-hNGF). Following polymer encapsulation, these cells were implanted into the lateral ventricle of four cynomolgus monkeys immediately following a unilateral transection/aspiration of the fornix. Three control monkeys received identical implants, with the exception that the BHK cells were not genetically modified to secrete hNGF and thus differed only by the hNGF construct. One monkey received a fornix transection only. All monkeys displayed complete transections of the fornix as revealed by a comprehensive loss of acetylcholinesterase-containing fibers within the hippocampus ipsilateral to the lesion. Control monkeys that were either unimplanted or received BHK-control (non-NGF secreting) cell implants did not differ from each other and displayed extensive losses of choline acetyltransferase and p75 NGF receptor (NGFr)-immunoreactive neurons within the medial septum (MS; 53 and 54%, respectively) and vertical limb of the diagonal band (VLDB; 21 and 30%, respectively) ipsilateral to the lesion. In contrast, monkeys receiving implants of BHK-hNGF cells exhibited a only a modest loss of cholinergic neurons within the septum (19 and 20%, respectively) and VLDB (7%). Furthermore, only implants of hNGF-secreting cells induced a dense sprouting of cholinergic fibers within the septum, which ramified against the ependymal lining of the ventricle adjacent to the transplant site. Examination of the capsules retreived from monkeys just prior to their death revealed an abundance of cells that produced detectable levels of hNGF in a sufficient concentration to differentiate PC12A cells in culture. These findings support the use of polymer-encapsulated cell therapy as a potential treatment for neurodegenerative diseases such as Alzheimer disease where basal forebrain degeneration is a consistent pathological feature. Moreover, this encapsulated xenogeneic system may provide therapeutically effective levels of a number of neurotrophic factors, alone or in combination, to select populations of neurons within the central nervous system.

The effects of finasteride (Proscar) on hair growth, hair cycle stage, and serum testosterone and dihydrotestosterone in adult male and female stumptail macaques (Macaca arctoides)

Finasteride, a 5 alpha-reductase inhibitor, was administered orally (1 mg/kg.day) for 6 months to six male and five female stumptail macaques. Vehicle was given to five male and five female animals over the same period of time. Hair weights in a defined 1-in.2 area of frontal scalp were measured periodically every 1-2 months, and serum was collected for measurement of testosterone and dihydrotestosterone. In addition, scalp biopsies were taken before and 6 months after treatment to evaluate the micromorphometry of hair follicles. Results showed that both male and female serum dihydrotestosterone levels were significantly reduced (60-70%) by finasteride treatment. Both males and females showed statistically significant increases in mean hair weight over the treatment period compared to controls (P = 0.034). In addition, there was a statistically significant increase in mean follicle length (measured histologically in scalp biopsies) compared to baseline in the finasteride-treated animals (P = 0.028). These data show that an inhibition of 5 alpha-reductase in the stumptail macaque can reverse the balding seen with age in both the male and female animals.

Percutaneous fluoroscopic gastrostomy. A safe option?

OBJECTIVE

To assess the safety of percutaneous fluoroscopic gastrostomy (PFG) tube insertion for enteral nutrition.

DESIGN AND SETTING

The records of 70 consecutive patients who had a PFG procedure at a tertiary referral hospital (Princess Alexandra Hospital) were analysed retrospectively.

MAIN OUTCOME MEASURE

Incidence of morbidity and mortality from PFG.

RESULTS

Sixty-nine of 70 procedures were successfully performed. There were two deaths secondary to aspiration pneumonia and a morbidity rate of 13%. These figures are comparable with results from other series.

CONCLUSION

PFG is a safe, effective procedure for enteral nutrition.

Detection of aneuploidy and chromosomal mosaicism in human embryos during preimplantation sex determination by fluorescent in situ hybridisation, (FISH)

Five couples at risk of producing offspring with X-linked recessive disease underwent in vitro fertilisation with a view to preimplantation determination of embryo sex and selective transfer of females. On day three postinsemination, one or two blastomeres were removed by embryo biopsy, and used for dual fluorescent in situ hybridisation with X and Y chromosome-specific DNA probes. In two cases, two female embryos were transferred and one pregnancy, (sex confirmed), is ongoing at 19 weeks. All eight embryos from one couple were of such poor quality that diagnosis was possible in one only. In the remaining two cases no embryos were transferred due to the detection of an abnormal number of X chromosome signals. Investigation of the biopsied embryos that were not transferred revealed evidence of mitotic non-disjunction in one and of complete X monosomy in a second. A surviving fetus with this latter constitution would have developed Turner syndrome and would also have been at high risk of X-linked disease. The use of fluorescent in situ hybridisation rather than the polymerase chain reaction allowed the detection of abnormal copy numbers of X chromosomes thus preventing the transfer of potentially abnormal zygotes.

Collagen characterization in volume-overload- and pressure-overload-induced cardiac hypertrophy in minipigs

Previous studies in several different species have shown reduced extractability of collagens in some types of cardiac hypertrophy (volume overload) but not others (pressure overload). The objective of the present study was to examine collagen proteins from the same species (minipigs) with both pressure-overload- and volume-overload-induced cardiac hypertrophy. Hypertrophy was induced by two methods: thoracic banding of the aorta to create pressure overload and arteriovenous shunt to cause volume overload in a porcine model. Collagen types I, III, IV, and V were isolated by pepsin digestion from normal and hypertrophied pig left ventricle tissues. Types I and III collagens from normal and hypertrophied samples, when separated from types IV and V, were digested with cyanogen bromide (CB), and the peptides were examined. Collagen concentration was increased in myocardium removed from hearts subjected to volume overload and unchanged in hearts subjected to pressure overload. The extractability of total collagen was unaffected in pressure-overloaded left ventricles but lower in samples from volume-overloaded hearts. CB digestion cleaved all of the types I and III collagens into similar smaller CB peptides with the exception of a 100-kDa peptide that was observed in both control and hypertrophied hearts. This peptide corresponds to one of the high-molecular-weight peptides found in canine heart tissue. The mature collagen cross-link hydroxylysylpyridinoline (HP) was identified in normal and hypertrophied types I and III collagen from porcine sources. Pressure-overload- and volume-overload-induced cardiac hypertrophy in the pig produced different alterations in the extracellular matrix.(ABSTRACT TRUNCATED AT 250 WORDS)

HPV DNA and the risk of squamous intraepithelial lesions of the uterine cervix in young women

A population-based case-control study of college students was undertaken to estimate the effect of a positive clinical test for human papillomavirus (HPV) DNA (the Virapap test) on the rate of squamous intraepithelial lesions (SIL) of the uterine cervix. When age, multiple lifetime sexual partners, and oral contraceptive use were controlled by logistic regression, the adjusted odds ratio (OR) for a positive Virapap test was 7.3 (3.3, 17) for a cytologic diagnosis of SILs and 3.4 (1.4, 8.5) for a cytologic diagnosis of squamous intraepithelial lesions of undetermined significance (equivocal atypia). When case status was defined as patients whose Pap smears were confirmed histologically as high-grade SIL, the adjusted OR was 10.3 (3.3, 32), reflecting the high proportion of individuals with SILs who were harboring high-grade squamous intraepithelial lesions. These results confirm the many previous findings of a strong association between HPV DNA, and demonstrate that strength of the association persists when important confounding variables are controlled. This suggests a causal role for HPV in cervical neogenesis. Believing that HPV infection is a major causal agent for cervical cancer precursors suggests that in this time of rapidly increasing HPV prevalence, especially among young persons, the incidence of cervical neoplasia will rise. This underscores the importance of increasing the availability, usage, and perhaps the frequency of Pap smear screening.

Management of traumatic oral-facial injury in the hemophiliac patient with inhibitor: case report

This report describes identification of Factor VIII inhibitor in a patient who then received immune tolerance therapy. The precipitating event was a traumatic orofacial injury that was nonresponsive to traditional factor-replacement therapies. An inhibitor complicates medical and dental management of the hemophiliac patient because it counteracts usual techniques of hemorrhage control using coagulation agents derived from Factor VIII (Monoclate--Armour, Blue Bell, PA). Successful identification and management of the inhibitor patient require communication and consultation between the physician and dentist, up-to-date knowledge regarding the hemophiliac patient's bleeding and infusion history and aggressive application of local adjunctive hemostatic therapies.

Transfer of embryos into the uterus: how much do technical factors affect pregnancy rates?

OBJECTIVE

Our objective was to identify the effect on outcome of (a) ultrasound-assisted embryo transfer, (b) the use of different embryo transfer catheters, and (c) the length of time the patients remain in the supine position after embryo transfer.

SETTING

The setting was a private fertility center.

SUBJECTS

This was a prospective study of 178 in vitro fertilization and embryo transfers (IVF-ET) and 63 frozen embryo replacements (FER).

RESULTS

The pregnancy rate was 28.7% following IVF-ET and 31.8% for FER. Ultrasound-assisted transfer did not affect the outcome (29 vs 30.3%). There was no difference in the performance of the Wallace and Frydman catheters with regard to outcome (30.3 vs 30.7%). Although there was an increase in pregnancy rate as the time interval in the supine position after ET increased, this needs a larger study.

CONCLUSION

The parameter studies did not affect the outcome of IVF/ET or FER. Some factors encouraged us to recommend ultrasound-assisted transfer in some cases, and the use of a Frydman catheter for transfer and to encourage the supine position after transfer for longer periods.

The influence of ovarian response on gamete intra-Fallopian transfer outcome in older women

Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged greater than or equal to 40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GIFT) cycles in women aged greater than or equal to 40 years to identify factors which affected the outcome. A maximum of four oocytes were transferred in GIFT as recommended by the Interim Licensing Authority; 61 women (17.5%) had a positive serum beta-human chorionic gonadotrophin, 35 (10%) had a miscarriage and 26 (7.5%) delivered live infants. The pregnancy rate was lower than with younger women while the conception loss was higher. Pregnancy and delivery rates increased as the number of oocytes retrieved increased but declined again if greater than 10 oocytes were retrieved. If 1-3 oocytes were retrieved, the pregnancy rate was 9.7% and the delivery rate was 3.9%; if 4-10 oocytes were retrieved, the pregnancy rate was 22.1% and the delivery rate was 10.1%, and when greater than 10 oocytes were retrieved, the rates were 17.6 and 5.9% respectively. The highest pregnancy rate was when four oocytes were transformed in GIFT (22.4%) and the delivery rate was 10.0%. An adequate response to long down-regulation with gonadotrophin-releasing hormone agonist was also a factor associated with high delivery rates (13.5%). We conclude that the delivery rate after GIFT in women aged greater than or equal to 40 years is low, but there is a subgroup who have an acceptable delivery rate because of a good ovarian response. In this group, pituitary down-regulation improves the outcome of treatment.

Third level hemodynamics: guiding clinical decisions

Hemodynamic monitoring is one of the most frequently used technologies in critical care nursing. But how often do critical care practitioners consider the underlying reason for monitoring these variables? What really is the oxygen balance in the cell? How does oxygen supply and demand figure into the hemodynamic equation? This article demonstrates how the imbalance of oxygen supply and demand at the cellular level is important to understanding the patient's hemodynamic status. It is followed by a continuing education packet you can use to teach the cellular principles of hemodynamics.

Inhibitors of collagenase in ligaments and tendons of rabbits immobilized for 4 weeks

Our laboratories have previously measured the capacity for collagenase production by normal and immobilized rabbit periarticular connective tissues (PCT), i.e., anterior cruciate ligaments (ACL), medial collateral ligament (MCL) and patellar tendon (PT). Rabbit limbs were immobilized for 4 weeks and then the tissues were cultured for 4 days. Collagenase and inhibitor (TIMP) were measured in the medium. Collagenase activity was significantly decreased in the medium from all experimental tissues, relative to the levels in contralateral control tissues. On the other hand there was no significant change in inhibitor levels in the three experimental tissues. These results support the idea that collagenase is decreased due to decreased enzyme expression and not to increased inhibitor production.

Cancer and health screening in Canterbury general practices

The general practitioners in the Canterbury Area Health Board area were surveyed for their screening policies for cancer and medical conditions. Responses were obtained from 210 (79%), 55% of whom had age/sex registers. Ninety-seven percent provided cervical smears, usually at 1-2 year intervals; 62% offered a female smear taker. Smears were initiated opportunistically by 76%, by age/sex register (47%) or on request by 27%. Breast cancer was screened by 69% using mammography and by 59% using breast physical examination; 73% taught breast self examination. Mammography was recommended every two years for women aged 50-64 years by 45% of responders, and annually to women aged 40-50 years by 19%. Mammography was initiated opportunistically by 88%, on request by 70% and using an age/sex register by 21%. Melanoma was screened by 66%, colorectal cancers in those at high risk by 42%. Testicular self examination was promoted by 43%. Ninety-one percent screened for hypertension, and 51% for hyperlipidaemia, 54% for diabetes mellitus in people without risk factors. Smoking (97%) and alcohol intake (82%) were usually inquired for, and safe sex practices by 59%. Established screening modalities were recommended by most practitioners, but the frequency exceeded current guidelines in many cases; opportunistic screening predominated.

Predicting cholangiocarcinoma in patients with primary sclerosing cholangitis before transplantation

Patients with primary sclerosing cholangitis are at an increased risk of developing cholangiocarcinoma, which is difficult to diagnose because the biliary tree is already distorted. Eleven patients with primary sclerosing cholangitis who underwent orthotopic liver transplantation at this hospital were evaluated. Four patients had coincidental histologically proved cholangiocarcinoma. Patients with cholangiocarcinoma in contrast to patients without tumour presented with rapid onset of persistent jaundice, pruritus, and weight loss associated with an appreciable rise in bilirubin (8x v 2x) and alkaline phosphatase (3.5x v 1.2x) over one year. Cholangiography and computed tomography showed appreciably dilated intrahepatic bile ducts (3/4 v 0/7). The diagnosis of cholangiocarcinoma could only be established before operation in one patient by fine needle aspiration cytology. Tumour was recognised at operation in one other. Histological examination of hepatectomy specimens showed that patients with cholangiocarcinoma had less advanced histological features of primary sclerosing cholangitis. Multiple areas of carcinoembryonic antigen positive epithelial atypia and carcinoma in situ were found in all patients with cholangiocarcinoma. Cholangiocarcinoma recurred in two patients at 14 and 39 months after transplantation. Superimposed cholangiocarcinoma can be predicted in most patients with cholangitis before transplantation, although a definitive diagnosis is difficult to make. Their prognosis after successful transplantation is guarded.

The reproductive outcome following a superhigh response to stimulation in gamete intrafallopian transfer program

A retrospective analysis was carried out to assess the outcome of gamete intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved (superhigh responders) from October 1987 through June 1989. There were 276 (13%) cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during the period. Clomiphene citrate and gonadotropin were employed for ovarian stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the pituitary down-regulation (67 cycles) protocol. A maximum number of four oocytes was transferred per GIFT (3.5 +/- 0.4). The mean number of oocytes retrieved was 14.7 +/- 4.4 (range, 11 to 35). A significantly younger age group (less than 30 years) of patients was noticed in the study (31.9), and fewer women aged 40 and over (6.2%), compared to the general population of our patients. The pregnancy rate was 33.3% (n = 92) per cycle, with a delivery rate of 23.6% (n = 64) per cycle; the pregnancy loss rate was 30.8%. The reproductive outcome was lower in women aged 40 and over (pregnancy rate was 23.5%, but delivery rate was only 5.8% per cycle). The delivery rate was lower in the clomiphene citrate- and gonadotropin-stimulated cycles (51.7% per pregnancy) in relation to gonadotropin-releasing analogue and gonadotropin cycles (76.6% per pregnancy) and significantly so compared with the pituitary down-regulation protocol (83.3% per pregnancy). We conclude that a superhigh response develops more in younger women, and in such circumstances, the use of pituitary down-regulation with gonadotropin-releasing hormone will improve the reproductive outcome.

Preincubation of human granulosa cells with gonadotrophin prevents the cloprostenol-induced inhibition of progesterone production

Human granulosa cells, from women undergoing ovum collection for in-vitro fertilization (IVF), will luteinize in vitro and provide a model for investigating the antigonadotrophic action of a prostaglandin F2 alpha (PGF2 alpha) analogue, cloprostenol, on granulosa-derived luteal cells. The granulosa cells were cultured in a defined medium and exposed to treatments during a preincubation period of 0 to 3 days and a final incubation with low density lipoprotein (LDL) from days 3 to 4. In the absence of human chorionic gonadotrophin (HCG), progesterone production was low, whereas exposure to HCG in the final incubation resulted in a 10-fold increase in progesterone concentrations. The inclusion of cloprostenol with HCG in the final incubation significantly (P less than 0.05) inhibited HCG-stimulated progesterone production. Exposure to HCG during the preincubation prevented the antigonadotrophic action of cloprostenol in the final incubation. The antigonadotrophic action of cloprostenol was retained when the granulosa cells were exposed to cloprostenol during the preincubation. Omission of LDL from the final incubation lowered the production of progesterone but the pattern of responses to HCG and cloprostenol were similar. Prevention of the antigonadotrophic action of cloprostenol after exposure to HCG may be a mechanism through which chorionic gonadotrophin can prevent regression of the corpus luteum in early pregnancy. Cloprostenol does not appear to inhibit LDL-stimulated steroidogenesis in human granulosa cells.

Congenital malignant melanoma of the eye

Twenty-three cases of congenital malignant melanoma have previously been reported. Here the authors report the first case of a congenital malignant melanoma arising in the eye. A newborn girl had a large pigmented ocular tumor, hepatomegaly, and multiple pigmented skin and choroidal lesions. The histopathologic diagnosis was of a malignant melanoma with hepatic metastases. The skin and choroidal lesions were considered to be congenital melanocytic nevi. The most plausible pathogenetic link between these two conditions was that the malignancy had arisen as a second-hit mutation within a choroidal congenital melanocytic nevus. Despite widespread metastases the baby, treated by surgery and chemotherapy, survives in good health, aged 2 years, 10 months.

Pregnancy following gamete intra-fallopian transfer (GIFT) with cryopreserved semen from infertile men following therapy to lymphomas or testicular tumour: report of three cases

Cryopreserved spermatozoa from men having treatment for lymphoma or testicular tumour have been reported to function sub-optimally. We report on three successful pregnancies following gamete intra-Fallopian transfer (GIFT) using such cryopreserved sperm samples. In one case, ovum donation was required since the woman had premature ovarian failure.

High-dose carboplatinum and VP-16 in treatment of metastatic adrenal carcinoma

We describe a case of a patient that presented to our center with Cushing syndrome and was found to have an extensive metastatic adrenal carcinoma. He underwent debulking of the abdominal disease followed by eight courses of VP-16/carboplatinum. The patient had a remarkable response and is currently alive and in complete remission.

Transfallopian tube embryo transfer: successful pregnancy outcome

A case of partial Asherman syndrome and blocked fallopian tube following complication of cesarean section is presented. Two IVF-ET attempts failed where difficulty at uterine embryo transfer was encountered. Transtubal embryos transferred 48 hr after transvaginal oocyte collection and in vitro fertilization resulted in an in utero pregnancy and delivery.

Neonatal hemangiomatosis presenting as infantile spasms

The previously unreported association of neonatal hemangiomatosis and infantile spasms is described in a 4-month-old female. The high mortality and morbidity of this neurocutaneous syndrome necessitates prompt recognition and investigation, to enable identification of associated internal lesions.

Codependency: a critique

An examination of the origins and development of the codependency concept finds it rooted in an obsolete disturbed-personality hypothesis. Both the current literature and treatment philosophy in the chemical dependency field reflect this perspective and continue to perpetuate a pathogenic view of wives who have chemically dependent husbands. Methods of treatment and the validity of treatment for what remains an unverified diagnostic entity are challenged on the grounds of professional ethics and therapeutic efficacy.

A center-based program for exercise change among black-American families

A center-based program was designed and implemented to promote aerobic physical activity among healthy Black-American families with children in the fifth through seventh grades. Ninety-four Black-American families were actively recruited and randomly assigned to an experimental or control group. Families in the experimental group were encouraged to participate in a program with the following features: one education and two fitness sessions per week for 14 weeks; educational sessions that included individual counseling, small group education, aerobic activity, and snack components; located in a convenient building cherished by the community; aerobic activity sessions in a fitness center outfitted and staffed according to modern characteristics; a variety of incentives including free transportation and babysitting and reminders to promote attendance. Percent participation was low, with about 20% participating in the desired fitness center sessions by the end of the program. As a result of low participation, no differences were detected between experimental and control groups on indicators of cardiovascular fitness. In postprogram interviews, conflicts with work and school events were the most commonly reported reasons for nonattendance. We concluded that because of difficulties in attendance, center-based programs appear to have limited value as the sole modality for intervention in public health programs for promoting physical activity among healthy, low income Black-American families with young children. More comprehensive community-based programs are likely to be needed.

Rhabdomyolysis and myoglobinuric renal failure

Rhabdomyolysis, a clinical syndrome resulting from the release of skeletal muscle cell contents into the plasma, is causally connected to up to 25 percent of all cases of acute renal failure. Critical care nurses need to be aware of precipitating factors and proper interventions in order to assure optimal function in this patient population.

Rhabdomyolysis and myoglobinuric renal failure

Rhabdomyolysis, a clinical syndrome resulting from the release of skeletal muscle cell contents into the plasma, is causally connected to up to 25 percent of all cases of acute renal failure. Critical care nurses need to be aware of precipitating factors and proper interventions in order to assure optimal function in this patient population.

Collagenases from periarticular ligaments and tendon: enzyme levels during the development of joint contracture

Our laboratories have previously demonstrated that normal rabbit periarticular ligaments, anterior cruciate ligaments (ACL), medial collateral ligaments (MCL) and patellar tendon (PT) secrete collagenase. In this current study we examined these connective tissues following an immobilization period of 4 weeks. In the ligaments producing collagenase, activity was expressed only in the control, not in the immobilized joint. Control and experimental patellar tendon samples produce collagenolytic activity, suggesting that the expression of enzyme is less affected in tendons as compared to ligaments. Characterization of these collagenases was carried out using an antiserum directed against rabbit synovial collagenase. We demonstrated that ligament (ACL) and tendon (PT) collagenases cross react with this antibody in a double immunodiffusion assay. Protein blots of PT, ACL and MCL collagenases identified one major species (Mr = 45,000) and a minor species (Mr = 50,000) of immunoreactive proteins in all three connective tissues. Differences between control and experimental enzyme levels appear to be due to less collagenase protein being produced by immobilized ligaments.

Transjugular liver biopsy--an Australian experience

During the four year period 1983-87 transjugular liver biopsy was performed on 67 patients (M43, F24) aged 17-79 yr (mean 45.6 yr). Standard percutaneous biopsy was contraindicated by coagulation disorders (95%) often with ascites (17%). Biopsies were taken using a specially modified Ross trans-septal needle passed into hepatic veins under fluoroscopic guidance. Hepatic tissue samples were obtained from the initial biopsy in 62 (93%) patients. In 30 consecutive transjugular biopsies a mean area of 38.2 mm2 per section (0.9-100 mm2) was available for histology compared with an area of 15.9 mm2 (9.3-48.8 mm2) in 50 consecutive percutaneous biopsies. Improved techniques of sample washing, sieving and fixation optimised separation of hepatic tissue from blood clot and fibrin. Four patients experienced significant complications but no deaths occurred. Individual diagnoses were changed in 17 patients as a result of biopsy findings. This study confirms the efficacy and relative safety of the transjugular approach in obtaining liver biopsies from patients with contraindications to standard percutaneous techniques.

Incidence of deep vein thrombosis after major abdominal surgery in Brisbane

There is some evidence that postoperative deep vein thrombosis (DVT) may be commoner in cool than in warm climates. To determine whether this complication is less common in the subtropical climate of Brisbane than in more temperate locations, the incidence of DVT after major abdominal surgery was assessed by 125I fibrinogen scanning. In order to avoid overestimating the incidence of DVT, abnormal scans were accepted as diagnostic only if the DVT was confirmed by venography or if the abnormality on the scan fulfilled more stringent criteria than have previously been applied. Thirty-six of 152 patients (24 per cent) developed a DVT; this incidence was significantly lower than in one previous study from Melbourne and higher than that found in South-East Asia and East Africa, but was not significantly different from that reported from Sydney, Japan and several centres in North America and Britain. There was no apparent seasonal variation in the incidence of the complication. The geographical variation in incidence of postoperative DVT may have been overestimated in previous reports and may be at least partly due to variations in screening technique.

RNA is covalently linked to SV40 large T antigen

RNA is shown to be covalently linked to the large tumor antigen (TAg) of simian virus 40 (SV40). Proteolytic digestion of TAg, isolated in the presence of ribonuclease inhibitors from SV40 transformed Balb/c mouse cells, generated a specific phosphopeptide of high charge heterogeneity that was strongly retained on DEAE-cellulose in the presence of 7 M urea. Hydrolysis of this peptide with RNAase released the four standard ribonucleotide monophosphates. Analysis of peptide digestion products showed that the RNA is attached to TAg through a phosphodiester linkage between the beta-hydroxyl of a serine and the 5' phosphate of an invariant cytidine residue. The methods applied to SV40 TAg can be applied to other proteins, including cellular oncogene products, to investigate the possibility of covalent protein-RNA interactions.

Collagenase production by rabbit ligaments and tendon

Three periarticular connective tissues from normal rabbits were examined for collagenolytic activity. Enzyme activity was secreted by cultures of anterior cruciate ligament (ACL), medial collateral ligament (MCL) and patellar tendon (PT). A lag period of six days or more was often observed prior to the detection of active collagenase. We attributed this to the presence of an excess of inhibitor in the early days of culture. We quantitated the amount of enzyme and inhibitor produced in 13 days. The levels of collagenase in the ACL and MCL were comparable. The PT, however, consistently secreted more enzyme than the two periarticular (ACL and MCL) ligaments. The reaction products were analyzed for all three collagenases and compared to those generated by the rabbit skin enzyme. We observed the characteristic TCA and TCB collagen fragments for MCL and PT enzymes. Collagen cleavage by the ACL cultures resulted in a product with a molecular weight intermediate between the alpha 2 chain and the TCA piece. These data suggest that quantitative and qualitative differences exist in the ability of these similar connective tissues to degrade collagen.

Topical corticosteroids for skin disorders in infants and children

Topical corticosteroids are an essential part of the treatment regimen of children with atopic eczema and a number of other inflammatory dermatoses, such as infantile seborrhoeic eczema, pompholyx and contact dermatitis. A special form of treatment, the 'wet wrap technique, has been found to be effective in treating children with acute erythrodermic eczema in an inpatient setting. Therapy usually lasts for 3 to 5 days and is useful as crisis intervention therapy. On the other hand, in some conditions, for example pityriasis alba, perioral eczema or juvenile plantar dermatosis, therapy with these agents is generally not required or may not be useful. It is important to remember that care must be taken when a topical corticosteroid is prescribed in children, since this age group is particularly at risk of developing side effects. Thus, the patient should be monitored closely, and potent agents should be avoided.

Cellular and genetic properties of two melanoma cell lines established from the same tumor

We report here the detailed cellular and genetic analysis of two new human melanoma cell lines established from the same tumor biopsy. Although derived from the same tumor biopsy, the two lines differed in their method of in vitro culture establishment with one line (HA-A) grown first in agar culture and then transferred to liquid culture, while the second cell line (HA-L) was established directly from cells grown in liquid culture. Detailed characterization of both cell lines was performed using techniques to analyze their cytogenetic, surface marker, morphology (light and electron microscopy), growth (in agar and in nude mice), and drug sensitivity profiles in comparison to the original tumor biopsy. Our results revealed no significant biologic or genetic difference between the two cell lines established by different culture techniques. Our results suggest that in some cases agar culture prior to liquid culture may be useful in establishment of human tumor cell lines.

Insulin stimulates secretion of a collagenase inhibitor by Swarm rat chondrosarcoma chondrocytes

Swarm rat chondrosarcoma chondrocytes produce an inhibitor of collagenase similar to that found in bovine articular chondrocytes and extracts of bovine scapular cartilage. These cells synthesize normal levels of cartilage type proteoglycans when cultured in serum free medium with insulin. Collagen synthesis is also increased when insulin is added to chondrosarcoma chondrocytes. We have demonstrated that insulin stimulates collagenase inhibitor production by these chondrocytes. Enhancement of inhibitory activity occurs over the range of 10 to 1000 ng/ml. A 3.2 fold stimulation was observed at a concentration of 1 microgram/ml. There was a lag period of 24 to 48 hours before the insulin effect became evident. Latent or active collagenase was not detectable under these conditions. These results suggest that the hormone insulin controls the levels of collagen in this tumor by stimulating synthesis of collagen and inhibitors of collagenase.

Iron-transferrin-induced increase in protein kinase C activity in CCRF-CEM cells

Iron transferrin has been found to induce a mean 10-fold increase in the activity of protein kinase C in CCRF-CEM cells. This increase was not detectable up to 45 min after treatment of cells with iron transferrin, although after 60 min, a maximal increase in enzyme activity was observed. Similarly, iron transferrin at concentrations of 0.1-0.5 microgram/ml did not alter protein kinase C activity, while concentrations of iron transferrin of 1-100 micrograms/ml induced a maximal increase in enzyme activity. Apotransferrin and iron in the form of ferric citrate, as well as complexes of transferrin with copper, nickel, zinc, manganese, and cobalt did not increase protein kinase C activity. Additionally, CCRF-CEM cells pretreated with either actinomycin D or cycloheximide and then incubated with iron transferrin did not exhibit increased enzyme activity. Treatment with iron transferrin was found to have no effect on protein kinase C activity in normal human peripheral blood lymphocytes and in HL60, Daudi, and U937 cells. However, normal lymphocytes stimulated with phytohemagglutinin for 48 hr exhibited a 2-fold increase in protein kinase C activity following treatment with iron transferrin. These results indicate a specific effect of iron transferrin on protein kinase C activity in CCRF-CEM cells and in mitogen-stimulated human lymphocytes that may occur through increased synthesis of the enzyme.