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8044036 | Sexual disorders in Huntington's disease. | This study assessed the frequency and type of sexual disorders associated with Huntington's disease (HD) in an unbiased sample. Of 39 HD patients and 32 of their partners, 82% and 66%, respectively, had one or more sexual disorders by DSM-III-R criteria. The most frequent for both groups was hypoactive sexual disorder. Significantly more patients who had both inhibited orgasm and increased sexual interest also had paraphilic disorders. Findings support the hypotheses that sexual disorders are frequent among HD patients and their partners and that sexual disorders among HD patients may take the form of increased sexual interest or paraphilias. The association between inhibited orgasm, increased sexual interest, and paraphilic disorders will require further investigation but suggests a possible etiology for some paraphilias. |
8044035 | Screening patients with traumatic brain injuries for substance abuse. | Substance abuse frequently accompanies and complicates serious traumatic brain injury (TBI). An important prerequisite to providing assistance to TBI patients is the ability to identify substance abuse accurately. The authors prospectively evaluated 10 consecutive admissions to a TBI program using four substance abuse screening tools: the CAGE questions, the Brief Michigan Alcohol Screening Test (BMAST), the Substance Abuse Subtle Screening Inventory, and the Addiction Severity Index. The CAGE questions and the BMAST were found to be easy to administer and very sensitive as well as specific for substance abuse in this population. The authors conclude that all patients with traumatic brain injuries should be screened for substance abuse by using either the CAGE questions or the BMAST. |
8044034 | The prevalence of traumatic brain injury and co-occurring disabilities in a national household survey of adults. | This original point prevalence study provides sociodemographic characteristics and Canadian household prevalence rates of adults (15 years and older) with disability who have survived a traumatic brain injury (TBI) and the type, number, and prevalence rates of co-occurring disabilities. This report is based on the Health and Activity Limitation Survey, a national survey conducted by Statistics Canada in 1986-87. The overall household prevalence rate of TBI is 62.3/100,000 adults (95% confidence interval = 54.0, 70.5). Gender-specific rates are 81.3/100,000 males and 44.2/100,000 females, with a 1.8:1 male-to-female ratio. Rates are highest in the 45-64 age range, 3 times those in the 15-24 age group. Eighty-four percent of adults with TBI have co-occurring disabilities (median = 2), the most prevalent being limited mobility and agility. |
8044033 | Catatonic disorder due to general medical conditions. | Catatonia is a neuropsychiatric syndrome that may present a difficult diagnostic dilemma. Catatonic disorder due to general medical conditions must be considered in every patient with catatonic signs. Four patients with this disorder are presented. In these patients, general medical conditions associated with catatonic disorder included dystonia, HIV encephalopathy, progressive multifocal leukoencephalopathy, encephalitis, and renal failure. Three of these patients had multifactorial presentations of medical conditions or prior psychiatric disorders. A critical literature review concerning catatonia and associated nonpsychiatric medical conditions only infrequently supported causal relationships between organic factors and the development of catatonia. The majority of patients have multifactorial etiologies. |
8044032 | The neuropathologic basis of major affective disorders: neuroanatomic insights. | Attempts to elucidate the pathophysiology of symptom production in mood disorders can be enhanced by information from two sources. First, insights into localization can be gained from the secondary mood disorders; these clinical problems suggest the brain regions that, when altered, are associated with specific symptoms. Second, both structural and functional brain imaging suggest specific regions where abnormalities are associated with mood disorders. Data that emerge from these sources implicate the basal ganglia, frontal cortex, and temporal lobes in the production of mood disorder symptoms. However, the specific neuroanatomic subregions involved and the associated biochemical changes await full elucidation. |
8044031 | Repetitive and compulsive behavior in frontal lobe degenerations. | The authors review the relationship of repetitive behaviors to frontal lobe degenerations and report the repetitive and compulsive behaviors, radiologic imaging findings, and neuropathology of 3 patients with dementia secondary to frontal lobe degeneration. These 3 patients and 78% of 46 proven pathologic cases of frontal lobe degeneration described in the literature demonstrate repetitive behaviors ranging from motor stereotypies to complex obsessive-compulsive disorder. This review suggests that combined damage to the frontal lobe, caudate nucleus, and globus pallidus may account for the repetitive behaviors seen in frontal lobe degenerations, idiopathic obsessive-compulsive disorder, and other neuropsychiatric diseases. |
8044028 | Human hemofiltrate as a source of circulating bioactive peptides: determination of amino acids, peptides and proteins. | Human hemofiltrate (HF) was evaluated regarding its content of free amino acids, proteins, and regulatory peptides. Human HF was obtained from patients with end stage renal disease (ESRD). In contrast to plasma it mainly contains low and middle weight molecules < or = 45 kDa. The content of free amino acids, peptides, and proteins in pooled filtrate was determined by amino acid analysis using ortho-phthaldialdehyde/fluorenyl methyl chloroformate (OPA/FMOC) precolumn derivatization. The total amount of peptides and proteins in human HF is 49.4 mg/L (n = 8). The levels of all free amino acids (230 mg/L) and the concentration of some regulatory peptides like insulin, endothelin, gastrin, vasopressin and angiotensin II were similar compared with blood plasma. The amount of peptides and proteins detected in the filtrate was around 0.07% of total plasma proteins, and consisted mainly of smaller proteins and peptides as shown by size exclusion chromatography (SEC). The presence of large proteins in plasma is reduced by a factor of 1500 after filtration. We conclude that human hemofiltrate is a valuable source for the large-scale extraction of regulatory peptides. |
8044029 | Reversed-phase HPLC separation and chromatographic-spectral characterization of 17 beta-(2'-Thiazolyl)androst-5-en-3 beta-ols and their acetates. | Simple isocratic HPLC separation of a series of thiazolyl steroids with the 17 beta-2' linkage is described. The chromatographic and spectral characterization utilizes both on-the-fly UV spectral maxima and absorbances changes. |
8044027 | Chiral separation of amines by high-performance liquid chromatography after tagging with 4-(N,N-dimethylaminosulphonyl)-7-(2-chloroformylpyrrolidin-1-yl)- 2,1,3-benzoxadiazole. | Chiral tagging reagents, 4-(N,N-dimethylaminosulphonyl)-7-(2-chloroformylpyrrolidin-1 -yl)-2,1,3- benzoxadiazole (R(+)-DBD-Pro-COCl and S(-)-DBD-Pro-COCl), react with mirror image enantiomers of amines to produce corresponding diastereomers in the presence of pyridine as a catalyst. The maximal excitation and emission wavelengths of the resulting diastereomers were ca. 450 nm and 560 nm, respectively. The diastereomers derived from some aliphatic amines were resolved by a reversed-phase chromatography with water-acetonitrile or normal-phase chromatography with n-hexane-ethyl acetate as the eluent. The reactivities of both enantiomers of DBD-Pro-COCl to chiral amines were almost comparable, whereas a slight difference of fluorescence intensity was observed with S(-)-DBD-Pro-COCl. When (S-)-DBD-Pro-COCl was used as the derivatization reagent, amines corresponding to S-configuration were eluted faster than R-configuration. The opposite elution order was obtained with the use of R(+)-DBD-Pro-COCl, instead of S(-)-DBD-Pro-COCl. The Rs values obtained from 1-cyclohexylethylamine (CEA) having aliphatic ring structure was larger than those of amines (1-(1-naphthyl)ethylamine (NEA) and 1-phenylethylamine (PEA)) having aromatic ring structures. |
8044026 | Isolation and purification of three glucuronides of antipyrine. Proposal for an original analytical method for quantitation of sulpho- and glucuroconjugated metabolites. | The determination of the concentrations of antipyrine metabolites in biological fluids is hampered by the difficulty in obtaining pure conjugated compounds to be used as standards. Most authors have proposed determination of total forms by high performance liquid chromatography (HPLC) after deconjugation of these metabolites using chemical or enzymatic hydrolysis. Up to now there is no satisfactory hydrolysis method for the study of all antipyrine metabolites. The situation is further complicated by the fact that the deconjugated metabolites are highly unstable whichever technique is being used. Because of the lack of stability of all these molecules it has been necessary to isolate the glucuroconjugated compounds from urine. We describe a method which allows us to obtain highly purified glucuroconjugated metabolites of antipyrine. Sulphoconjugated compounds have been synthesized previously. We are thus able to propose a chromatographic procedure which allows us to determine simultaneously all stable phase I and phase II metabolites of antipyrine in biological fluids without any step of extraction. This analytical technique allows us to study the activity of the different isoenzymes implicated in the metabolism of antipyrine. |
8044025 | UV-transparent, replaceable agarose gels for molecular-sieve (capillary) electrophoresis of proteins and nucleic acids. | Gels of methoxylated agarose (gelling point 25.6 degrees C) and other low-melting agarose derivatives compare favorably with cross-linked polyacrylamide gels for capillary and slab molecular-sieve electrophoresis of proteins and DNA. These agarose gels can be pressed out of the capillary following a run and replaced by an agarose solution with a temperature of 35-40 degrees C. Gelation occurs upon lowering temperature and the same capillary can thus be reused for another analysis with a fresh gel. The methoxylated, non UV-absorbing agarose gels are, accordingly, replaceable, which makes them very attractive for series analyses with modern, automated capillary electrophoresis apparatus. The high resolution of these agarose gels is demonstrated with a separation of an albumin sample into monomers, dimers, trimers, tetramers, pentamers, hexamers, heptamers, and of DNA fragments. |
8044024 | Improved thin layer chromatographic resolution of PTH amino acids with some new solvent systems. | Three new solvent systems, pyridine: benzene (2.5:20, v/v), methanol:carbon tetrachloride (1:20, v/v) and acetone:dichloromethane (0.3:8, v/v), for the resolution of a mixture of 18 PTH amino acids have been reported. Using these solvent systems, various combinations of PTH amino acids which had previously posed resolution problems have been resolved and identified. |
8044022 | Automated HPLC analyses of drugs of abuse via direct injection of biological fluids followed by simultaneous solid-phase extraction and derivatization with fluorescence detection. | An automated system is described for the simultaneous extraction and derivatization of nucleophilic compounds from various biological media. The method includes the use of a solid-phase reagent containing a 9-fluorenylacetate activated ester. The reagent is based on a controlled pore, polystyrene divinylbenzene support prepared through a silica template procedure. An X-Y-Z robotic arm equipped with a needle is used in conjunction with a syringe pump for aspirating and dispensing samples and standards into the HPLC system. A precolumn cartridge containing the solid-phase reagent is put on-line in place of the fixed-volume injection loop. Injections of biological fluids such as urine or plasma with minimal sample treatment and handling are made directly into this reactor. The analytes are derivatized as they are extracted, allowing virtually unlimited sample volumes to be injected. The polymeric cartridge can be used for up to 100 injections without accruing unacceptable reductions in sensitivity. A detection limit of 500 p.p.t. (parts per trillion) of amphetamine in urine was achieved with this system. |
8044023 | Identification and verification of the anabolic steroid boldenone in equine blood and urine by HPLC/ELISA. | An enzyme linked immunosorbent assay (ELISA) was developed to detect the anabolic steroid boldenone in equine blood and urine. The polyclonal antiserum was raised in rabbits, employing boldenone-17-hemisuccinate-bovine serum albumin as antigen. Boldenone-17-hemisuccinate-horseradish peroxidase served as enzyme conjugate. Sensitivity of the assay was 26.0 +/- 3.0 pg/well. Among the endogenous steroids tested only progesterone and testosterone exhibited moderate cross-reactivities, 3.4 and 2.5%, respectively. These cross-reactivities are of no importance for the boldenone assay. For the reduction of background levels, screening for boldenone of equine serum was performed after extraction. Urine samples were determined directly after dilution, omitting hydrolysis of boldenone conjugates. Positive screening results were confirmed by means of two independent HPLC systems combined with off-line detection, employing the boldenone ELISA. Methandienone served as internal standard to ascertain retention factors. In horses treated with boldenone-17-undecylenate the presence of boldenone in serum was confirmed up to 28 days and in unhydrolyzed urine up to 56 days post applicationem. |
8044021 | A simple method for the determination of YM060 in plasma and urine by high performance liquid chromatography. | We developed a simple method for the determination of YM060, a new 5-HT3 receptor antagonist, in plasma and urine. The method has good accuracy and precision, and sufficient sensitivity to allow use in pharmacokinetic studies of YM060 in humans and laboratory animals. |
8044020 | [Mechanism of decoction of guizhi tang on dual-directional thermoregulation. Effect on the action of bombesin]. | Hypothermia induced by administration of bombesin into the lateral ventricle of brain in cold exposed rats could be inhibited by Guizhi Tang (GZT). The GZT could also reverse the potency of fever induced by injection of [D-Phe12] bombesin, a bombesin receptor antagonist, into the brain of febrile rats. But there was no effect of GZT on body temperature when bombesin and [D-Phe12] bombesin were simultaneously injected into the lateral ventricle of cold exposed rats. These studies indicated that the dual-directional thermoregulation of GZT was carried out partially by affecting the bombesin receptor in thermoregulation center of hypothalamus. |
8044019 | [Determination of hepatocyte adrenergic alpha 1 receptor and study on actions of nourishing yin and replenishing qi drugs in experimental hyperthyroid rats]. | In this study, hyperthyroid rat models (group 1) were established by daily intramuscular injections of thyroxine for 7 days. Group 2 were hyperthyroid rats receiving at the same time Nourishing Yin and Replenishing Qi drugs (Ophiopogonis japonis, Pseudostellariae heterophylla and Rehmannia glutinosa). Normal rats served as controls. Group 1 and group 2 rats showed manifestations of hyperthyroidism, higher rectal temperature, increased O2 consumption, as well as significantly higher serum TT3 and TT4 levels. Receptor proteins of liver cell membrane were prepared. Receptor binding assay was performed using 3H-prazosin (adrenergic alpha 1 receptor antagonist) as radioligand, maximal binding capacity (Bmax) and dissociation constant (Kd) were calculated from Scatchard curve. It was found Bmax (fmol/mg protein) in model groups were lower than that of the control group, but the differences were not statistically significant. Kd (nM) in group 1 was significantly lower than that of control group (2.32 +/- 1.09 vs 5.42 +/- 2.54, P < 0.05), indicating that receptor affinity was increased in hyperthyroid rats. Kd in group 2 (3.11 +/- 1.48) was intermediate between that in group 1 and controls, suggesting that these Chinese herbal medicine might have an effect in lowering receptor affinity and the peripheral conversion of T4 to T3. |
8044018 | [Depth of getting qi in clinical practice]. | Based on the type of build being fat, medium and thin to determine the depth of getting Qi (DGQ) in acupoints, and based on the aforesaid three types of build to verify the difference of DGQ of neck, trunk, upper-limb and lower limb with T test. The result showed that the DGQ of fat man group was deeper, the DGQ of thin man group was more superficial (P < 0.01), the DGQ of neck was more superficial than that of trunk, upper and lower limb, and the standard deviation (SD) of neck DGQ was +/- 0.1 cm, that of trunk, upper and lower limbs was +/- 0.2cm. Following finding has been observed, the DGQ of patient with nervousness and allergic constitution showed more superficial, while the DGQ of cancer and apoplexy patients showed deeper than that of ordinary patients. |
8044017 | [Alteration of cocaine, morphine and nicotine levels in serum of opiomaniacs treated by jie du ling]. | 20 Opiomaniacs were treated by Jie Du Ling consisted of some Chinese herbal medicine. Cocaine, morphine and nicotine levels in serum of 20 cases before and after treatment and 20 subjects for control were measured simultaneously by means of radioimmunoassay. The results showed that cocaine, morphine and nicotine levels in patients serum before treatment were significantly higher than that of control (P < 0.001), while the level of above-mentioned 3 substances in patient's serum after treatment were significantly lower than that of before treatment (P < 0.001). It is proved that Chinese medicinal herbs could significantly reduce the levels of cocaine, morphine and nicotine after treatment in clinical practice. It offered evidence for Chinese herbal medicine in stopping opiomania. |
8044016 | [Observation on 17 patients of radio-ulcer with combined traditional Chinese medicine and Western medicine therapy]. | 34 radioulcer patients were divided randomly into two groups, the TCM-WM group (17 cases) and the WM group (17 cases). The TCM-WM group was treated mainly with oral administration and external treatment of TCM plus wet-compressing with antibiotics, gradual elimination of necrotic tissue and symptomatic treatment. The latter group was treated with Western medicine therapy only including pain-killer, antibiotics, debridement and dressing change. The results showed that the total effective rate of TCM-WM group was 94.1%, significantly higher than that (52.9%) of WM group (P < 0.01). Meanwhile the mean pain-ceasing time, wound-cleaning time and effective time of the TCM-WM group were 62.18, 80.16 and 107.55 days respectively, significantly shorter than those (97.29, 116.86 and 169.83 days) of WM group (P < 0.010-005). This study suggested that the TCM-WM therapy could reduce pain quickly, clean wound well, promote granulation growth and epithelium regeneration so as to accelerate ulcer healing. |
8044015 | [Observation on blood flow changes in 34 cases of progressive systemic scleroderma treated with Chinese herbal medicine]. | The blood flow change of 34 progressive systemic scleroderma (PSS) patients were examined. The amplitude proved to be lowered markedly than healthy subjects. All patients were treated with the basic prescription of PSS as the principal method, combined with infusion of Mailuoning injection in 500 ml of 5% glucose. The course of treatment lasted three months to one year. The result of treatment showed that the abnormal blood flow of extremities of all patients were improved remarkably. Marked improvement rate and total effective rate were 70.5% and 100% respectively. Significant improvements in clinical and laboratory parameters were observed. It revealed that there was a close relationship between the occurrence and development of PSS and blood circulation. It is assumed that the pathogenic mechanism of PSS is Deficiency of vitality and Excess of pathogenic factor (Stasis of Blood), and the Qi tonifying and Blood activating, hard lump softening and mass dissolving medicinal herbs according to Syndrome Differentiation of TCM should be used. |
8044013 | [Clinical study of the treatment of fallopian tube obstruction with catheter recanalization and blood stasis removing drugs]. | 50 patients with fallopian tube obstruction were initially treated by catheter recanalization, and then randomly divided into two groups. Chinese medicine group (CMG) treated with Tongjingbao and Angelicae Complex Injection and Western medicine (Gentamycin, Dexamethasone, Chymotrypsin) group (WMG) as a control. The course of treatment was three months. Before and after treatment, the hemorheology change was analysed. After treatment, all patients except subsequent pregnancy were repeatedly performing hysterosalpingography. The results showed effective rate of recanalization was 94%; corrected pregnancy rate was 100% in CMG and 50% in WMG; the reocclusion rate of fallopian tube was 9% in CMG and 25% in WMG (P < 0.05). The difference of hemorheology change between two groups was significant (P < 0.01) and it was also different before and after treatment in CMG (P < 0.01). This study showed that catheter recanalization was effective in recanalizing the mechanical occluded fallopian tube. The Chinese medicine would inhibit the reocclusion and re-adhesion of tube. |
8044012 | [Observation on cunkou pulse picture, sphygomogram and forearm rheohemogram of acute stroke patients]. | Observation of Cunkou pulse picture, main wave of sphymogram (MW) and foreman rheohemogram and blood pressure (BP) were made on 41 acute stroke patients divide into two groups according to Syndrome Differentiation of TCM; including those involved in viscera and in meridian. The difference between these two groups were significant. The MW, the forearm blood volume (FBV) and BP were all significantly higher in those involved in viscera than that of in meridian. In the different phases of disease course, the MW, FBV and BP changed gradually. During recovery, the MW, FBV and BP were lowered gradually, and finally it remained stable. |
8044011 | [Clinical and experimental research of buyang huanwu tang granule in treatment of ischemic apoplexy]. | 38 cases of ischemic apoplexy were randomly divided into three groups. Among them 26 cases were treated with type I and type III of Buyang Huanwu Tang Granule (BYHWTG) for 10 weeks, respectively. The other 12 cases served as a control group. The results showed that clinical cure and markedly effective rate were 42.3%, the total effective rate was 88.5% in BYHWTG group. The effective rate of BYHWTG type I for the treatment of ischemic apoplexy was 100% and it was superior to type III (84.6). BYHWTG could significantly improve hemorheologic indexes in the patients of ischemic apoplexy. The activity of RBC sodium pump was markedly raised from 0.210 +/- 0.003 to 0.250 +/- 0.008 1/h (P < 0.001) in BYHWTG type I. The results of this study suggested that BYHWTG had evident efficacy in the treatment of ischemic apoplexy. |
8044010 | [Clinical effect and experimental study of xijian tongshuan pill]. | Xijian Tongshuan pill (XJTS), consisted of Siegesbeckia orientalis, Moschus moschiferus, Hirudo nipponica, Prunus Persicae, Carthamus tinctoruis, Ligusticum wallichi, Panax notoginseng, Angelica Sinensis, Borneolum, etc, were used in treating 70 patients with cerebral thrombosis. The marked effective rate was 82.9%, total effective rate was 96.7%. In control group A, Dextranum and Venoruton were used, in control group B cyclandelate capsule were used. The marked effective rate was 61.7% and 61.1% respectively, the total effective rate was 81.7% and 83.3%. The differences were significant (P < 0.01). The improvement of blood rheology and CT of brain were also significant (P < 0.01). The experiment proved that XJTS pill could inhibit and delay the thrombosis of rabbit, inhibit the platelet aggregation. Acute and subacute toxicity tests proved that XJTS pill was safe and effective. |
8044006 | [Effect of TRH and buzhong yiqi tang on natural killer cell activity and endocrine in stress mice]. | Both thyrotropin-releasing hormone (TRH) and Buzhong Yiqi tang (BZYQT) were studied on their effect on splenic natural killer (NK) activity and hypothalamic-hypophyseal-thyroid (HHT) axis of stress mice. TRH (0.2 microgram/mouse/day, ip.) and BZYQT (0.2g/mouse/day, po.) had been given for 3 days before the amputation of right hind leg of mice were performed. Result showed that the TRH and BZYQT had rarely any effect on splenic NK activity and HHT axis recovery when they were used separately, but when used in combination they could increase the NK activity of splenic cells significantly in comparing with control group (from 8.32 +/- 4.50% to 15.60 +/- 4.18%, P < 0.05), while the HHT axis recovered to normal level at 24 hours after the amputation. The result suggests that there was a synergistic effect between TRH and BZYQT, and which exerted beneficial effect to the HHT axis stabilization and splenic NK activity recovery. |
8044005 | [A study on Mechanism of prevention and treatment of gastric ulcer with Os sepiella in rats]. | The Os Sepiella maiudrone (OSM) could markedly inhibit the stress-induced gastric mucosal lesions and promote the healing of acetic acid-induced gastric ulcer in rats were reported previously. In order to demonstrate its mechanism, the effects of OSM on acidity of gastric juice, combined mucus content in gastric wall, DNA synthesis, gastric movements, the gastric contents of prostaglandin E2 (PGE2) and cAMP of gastric tissue were examined. The results showed that OSM could neutralize the gastric acid, promote the production of cAMP and PGE2 in gastric tissue. These suggested that the neutralization of gastric acid and enhancing the gastric mucosal cytoprotection by OSM would play a role in preventing and curing gastric ulcers in rats. |
8044004 | [Quality of clinical trials of Chinese herbal drugs, a review of 314 published papers]. | The study was based on a review of clinical trials for herbal drugs published in various journals. Three journals selected were Chinese Journal of Integrated Traditional and Western Medicine (JITWM), Journal of Traditional Chinese Medicine (JTCM), and a provincial Journal of Traditional Medicine (JTM). In order to reflect different levels of the journal, each paper of the clinical trials of herbal drugs in the above-mentioned journals during the survey years, 1991, 1987 and 1980 (or 1981) was reviewed using a standard checklist and quantified through a score system. A total of 314 paper were reviewed, in which 179 in 1991, 82 in 1987, and 53 in 1980 and 1981. Controlled trials were found in 86% of JITWM, 40.8% of JTCM, and 26.8% of JTM in 1991. Although there was an increased trend in the use or randomized trials, it still showed a lower proportion, respectively 52.9% in JITWM, 36.0% in JTCM, and 11.1% in JTM. We found that the quality of clinical trials in JITWM was the first, JTCM the second, JTM the third and showed a gradually improved trend with time. |
8044001 | [A study of paeonol injection on immune functions in rats]. | Paeonol is the main effective component of the traditional Chinese medicine, Paeonia suffroticosa. Paeonol has some therapeutic effects in resisting many species of bacteria and fungi. But the mechanism of such effects is still unclear. We used low dosage of paeonol injection (10-15 mg/kg) to observe its effect on the functions of the immune system of the Wistar's rats. The methods include peripheral blood ANAE+ lymphocytes (PBAL), leucocyte migrating inhibition factors (LMIF), specific rosette forming cells (SRFC) of spleen, and bacteria phagocytosis of polymorphonuclear neutrophil (BPP). The results showed that paeonol could enhance specific cellular immunity by raising the percentage of the PBAL (P < 0.01) and the release of LMIF (P < 0.01). Paeonol could also increase the BPP (P < 0.01). On the other hand, although it could increase the percentage of SRFC of the spleen, such an effect showed no significant difference (P > 0.1). These enhancing effects of the specific cellular immunity and the nonspecific phagocytosis functions of the immune system might be one of the mechanisms of the antibacterial effects of paeonol. The possible modulating activity of paeonol may develop a new applied field in clinical practice. |
8044000 | [Effects and mechanism of total saponins of Panax Notoginseng on anti-inflammation and analgesia]. | In this study the effects of total saponins of Panax notoginseng (TSPN) and electroacupuncture (EA) were compared. Liquid paraffin was intraperitoneally injected (0.1 ml/mouse) to establish the animal model with inflammation. The mice were randomly divided into 4 groups with different treatments for 7 days: EA group, TSPN group (100 mg.kg intraperitoneal administration), Naloxone (Nx) plus TSPN group and EA plus TSPN group. The pain threshold was measured by a detector (EQ-9E) and the nitroblue tetrazolium test (NBT) for polymorphonuclear neutrophil (PMN) bacteriocidal activity and the alpha-naphthyl acetate esterase (ANAE) histochemical staining for detection of the focal pattern lymphocyte subpopulation and the toluidine blue histochemical staining for detection of degranulation rate peritoneal mast cells were performed. The results showed that in TSPN, EA and EA plus TSPN group the pain threshold was elevated significantly, the enumeration of NBT positive PMN and the ANAE-F lymphocyte subpopulation was enhanced. All the above effects could be partially inhibited by naloxone. Between TSPN group and Nx group the degranulation rate of peritoneal mast cells had no significant difference. Since the TSPN and EA have similar effects e.g. anti-inflammatory, analgesic and immunomodulatory action, it suggested that the TSPN might be somewhat agonist of the opioid like peptide receptor without addiction side reactions. |
8043998 | [Relationship between fissured tongue with flow and components of saliva]. | Observation on 30 patients with fissured tongue (FT) and 42 normal subjects, through the measurement of flow and the elements of saliva, pH value, the Na and K content, SIgA, it was shown that: in FT patients, the flow of saliva and pH decreased, while the Na/K ratio and the content of SIgA increased (each P < 0.01, compared with the normal). It was also showed that the formation of FT has to a certain extent something to do with the electrolyte disturbance in aqueous solution, malnutrition, as well as immunity and endocrinic function of patients. |
8043997 | [Study of Andrographis paniculata extracts on antiplatelet aggregation and release reaction and its mechanism]. | 63 patients of cardiac and cerebral vascular diseases were observed at 3 hours and/or one week after taking Andrographis paniculata (AP) extracts. Results showed that both 1 min. and 5 min. platelet aggregation induced by ADP were significantly inhibited (P < 0.001), 33 cases of them were observed for one week. The aggregation rate was even significantly lower than that of 3 hours. Serotonin (5-HT) release reaction from platelet was observed in 20 volunteers taking AP. Result showed 5-HT released from platelet decreased (P < 0.01), but plasma 5-HT level remained unchanged. The ultrastructural observation showed that AP could inhibit the releasing of dense and alpha agranules from platelet and dilating of canalicular system. It suggested that a raise of platelet cAMP level might be the mechanism of antiplatelet effect of AP. |
8043995 | [Hemodynamic study on nitroglycerin compared with Salvia miltiorrhiza]. | This report investigated the hemodynamic changes of both nitroglycerin and Salvia miltiorrhiza (Co.) concerning pulmonary capillary-wedge (PCW), mean pulmonary artery pressure (MPAP), cardiac output (CO), cardiac index (CI), systemic mean pressure (SMP), and heart rate (HR). In 20 patients with heart diseases of normal cardiac function, nitroglycerin were compared with Salvia miltiorrhiza (Co.) using Swan-Ganz Catheter, which were self-compared. (1) Both drugs had the similar vaso-dilating effects, reduced the filling pressure of left ventricle and increased the cardiac output but different in the time of appearance and duration, particularly concerning CO and CI. (2) The effect of Salvia miltiorrhiza (Co.) was markedly superior to the nitroglycerin. The action of former was more persistent and the improvement of cardiac function was better than that of latter. |
8043996 | [Effect of ligustrazine on plasma lipid peroxidation, superoxide dismutase of the coronary heart disease]. | A clinical study on 59 remote myocardial infarction cases were divided randomly into treated group (31 cases) and normal control group (28 cases). Treated group used intravenously injected Ligustrazine 160 mg a day for 10 days. The plasma lipid peroxidation (LPO), superoxide dismutase (SOD) and sulfhydryl group were measured before and after treatment in the treated group, in comparing with normal control group. The results showed the levels of LPO significantly reduced (P < 0.01), and SOD, sulfhydryl group was obviously increased after Ligustrazine administration (P < 0.05). Attack of angina pectoris was reduced. Between these two group, the difference was significant (P < 0.05). Mechanism of Ligustrazine in reducing LPO and increasing SOD could be the inhibiting of platelet aggregation, regulating the TXA2/PGI2 ratio in plasma, protecting myocardial cell membrane and improving the myocardial ischemia. Ligustrazine could reduce the production of LPO due to the accelerating clearance of oxygen free radical. |
8043994 | [A study of classification and treatment of combined traditional Chinese medicine and Western medicine of 69 cases of aplastic anemia]. | Hemopoietic progenitor cells (BFU-E, CFU-E and CFU-GM) of 69 cases of aplastic anemia were cultured in vitro while the sensitivity of CFU-E and BFU-E to androgen was assayed. The suppressive effect of peripheral blood mononuclear cell (PBMNC) from patients on normal CFU-GM growth was also studied. Hence 69 cases of aplastic anemia were divided into three types: 10 cases of stem cell deficiency type, 30 cases of immuno-mediated type and 29 cases of androgen response type. According to above classification, different treatment programs were practiced using both TCM and western medicine. In the androgen response type, androgen and TCM were used and the effective rate reached 92.3%. In the immuno-mediated type, in addition to TCM. Immunosuppressive agents were cautiously used and the effective rate was 70.6%. As for the stem cell deficiency type, 10 patients' conditions were usually very severe so comprehensive therapeutical means were adopted and 3 cases were improved. The overall response rate of these three was 73.2%. These results showed that the treatment program under the direction of classification have greatly improved the curative effect. |
8043993 | [A study on combined acupuncture and enflurane anesthesia for craniotomy]. | The reinforcing effect of transcutaneous acupoint electric stimulation (TAES) with enflurane anesthesia during craniotomy was studied. 110 neurosurgical patients were randomly divided into three groups. Anesthesia was maintained with enflurane in group A (n = 40); in group B, enflurane anesthesia was supplemented by TAES with Han's acupoint nerve stimulator (HANS) at Hegu, Yuyao and Fengchi points on the operated side (n = 40); in group C, enflurane anesthesia was supplemented by TAES and scalp infiltration with 0.5% procaine (n = 30). The results showed that the minimum alveolar concentration (MAC) of enflurane in group B and C decreased 37.8-47.0% and 42.1-66.1% respectively than that in group A. The hemodynamics was more stable during operation, and the patients recovered faster after operation in group B and C. It was concluded that TAES with HANS significantly potentiated the anesthetic effect and decreased the side effects of enflurane during operation, and that the triple combination of TAES, enflurane and scalp infiltration with procaine proved to be a better anesthetic method for craniotomy. |
8043992 | Mercury deposits in neurons of the trigeminal ganglia after insertion of dental amalgam in rats. | An amalgam filling was inserted into the first upper molar of 12 rats and the animals were killed after 3-9 months. Tissue sections from the trigeminal ganglia and the brain stem were then investigated with a sensitive histochemical technique to trace mercury deposits. Within the trigeminal ganglia, nerve cells with mercury deposits were observed in seven out of 12 rats, whereas no mercury was detected in sections from the brain stem. The mechanism responsible for the accumulation of mercury in neurons of the trigeminal ganglia is discussed. |
8043991 | Effect of medium copper concentration on the growth, uptake and intracellular balance of copper and zinc in Menkes' and normal control cells. | The precise nature of the variation in cellular copper load against medium copper concentration is defined using a comprehensive logarithmically incremented series of medium copper concentrations ranging from low levels (4.8 p.p.b.) through 'normal' to toxic levels (40 p.p.m.) in which fibroblasts were grown followed by determination of intracellular content. Menkes' fibroblasts showed an unexpected plateau region of stable intracellular copper content against a change in medium concentration of over 100-fold, albeit only when sufficient copper was present in the medium (0.08-8.0 p.p.m.). Thus, Menkes' cells are clearly capable of balancing uptake/efflux providing copper availability allows. Simultaneous analysis of cellular copper and zinc load at various medium copper concentrations shows an indistinguishable intracellular copper:zinc ratio between the two cell lines. The nature of non-labeled copper uptake by fibroblasts over a 40 min and 7 day period is reported. During the 40 min period copper uptake (20 p.p.m.) was essentially the same in both cell lines. However, copper absorbed was superimposed upon large pre-existing copper pools in the case of Menkes' cells only. Advantages of techniques determining non-labeled copper in copper uptake/efflux experiments are discussed in the light of these results. Fibroblast growth studies showed that, compared with normal cells, Menkes' cells are significantly (P < 0.01) more growth sensitive to extended exposure to low copper concentrations. Thus, Menkes' disease appears to be not only a result of copper maldistribution but also a direct result of an inability of Menkes' cells to function normally in low copper environments. |
8043990 | Reactivity of Al(III) with membrane phospholipids: a NMR approach. | The complexes Al(acac)3 (1) (acac = 2,4-pentanedionate) and Al(malt)3 (malt = 3-hydroxy-2-methyl-4-pyronate) (2) react with DL-alpha-dipalmitoylphosphatidylcholine (DPPC) under a 1:1 molar ratio in CDCl3 at 37 degrees C, as shown by the substantial release of ligands (20-50%) from the metal coordination sphere (1H-NMR), by evident changes in the 1H-NMR spectrum of DPPC in the reaction mixture and by the appearance of a 31P-NMR signal due to metal-coordinated DPPC. 31P-NMR spectra reveal that both 1 and 2 also react with DPPC in water, in the presence of 1% Triton X-100 and Tris buffer. Under these conditions, 1 and 2 do not react with ghosts from human erythrocytes. On the contrary, the far less hydrolytically stable complex Al(lact)3 (lact = lactate) appears to be reactive under identical conditions, as shown by 31P-NMR spectra. |
8043988 | Diversity of siderophore genes encoding biosynthesis of 2,3-dihydroxybenzoic acid in Aeromonas spp. | Most species of the genus Aeromonas produce the siderophore amonabactin, although two species produce enterobactin, the siderophore of many enteric bacteria. Both siderophores contain 2,3-dihydroxybenzoic acid (2,3-DHB). Siderophore genes (designated aebC, -E, -B and -A, for aeromonad enterobactin biosynthesis) that complemented mutations in the enterobactin genes of the Escherichia coli 2,3-DHB operon, entCEBA(P15), were cloned from an enterobactin-producing isolate of the Aeromonas spp. Mapping of the aeromonad genes suggested a gene order of aebCEBA, identical to that of the E. coli 2,3-DHB operon. Gene probes for the aeromonad aebCE genes and for amoA (the entC-equivalent gene previously cloned from an amonabactin-producing Aeromonas spp.) did not cross-hybridize. Gene probes for the E. coli 2,3-DHB genes entCEBA did not hybridize with Aeromonas spp. DNA. Therefore, in the genus Aeromonas, 2,3-DHB synthesis is encoded by two distinct gene groups; one (amo) is present in the amonabactin-producers, while the other (aeb) occurs in the enterobactin-producers. Each of these systems differs from (but is functionally related to) the E. coli 2,3-DHB operon. These genes may have diverged from an ancestral group of 2,3-DHB genes. |
8043989 | Effect of taurine, L-glutamine and L-histidine addition in an amino acid glucose solution on the cellular bioavailability of zinc. | Radioactive zinc was used to study the effect of a binary parenteral nutrient solution, composed of amino acids and glucose, on zinc uptake by fibroblasts. The influence of addition of taurine, L-glutamine and of the increase in L-histidine content of the admixture was assessed. The pure mixture was highly toxic for cells and so it was diluted 1/5 in tyrode buffer with 2% albumin. As compared with cells incubated in the buffer containing albumin, zinc absorption was significantly higher (P < 0.05) in the presence of the amino acids of the mixture. Amino acids thus increased bioavailability by displacing zinc bound to albumin. When the histidine concentration in the nutrient medium (4.2 mM) was doubled, inhibition was noted after 30 min of incubation and zinc uptake thereafter remained comparable to that in histidine-free medium. The addition of glutamine (4.2 mM), usually not present in binary mixtures, resulted in significant differences as compared with glutamine-free control medium. Taurine (0.8 mM), led to a constant increase in zinc uptake by fibroblasts as compared with that obtained with taurine-free mixture. However, ultrafiltration showed that taurine was not able to displace zinc from albumin. |
8043987 | Adaptation of a Saccharomyces cerevisiae strain to high copper concentrations. | A strain of Saccharomyces cerevisiae has been adapted to increasing concentrations of copper at two different pH values. The growth curve at pH 5.5 is characterized by a time generation increasing with the amount of added copper. A significant decrease of cell volume as compared with the control is also observed. At pH 3 the cells grow faster than at pH 5.5 and resist higher copper concentrations (3.8 against 1.2 mM). Experimental evidence indicates that, after copper treatment, the metal is not bound to the cell wall, but is localized intracellularly. A significant precipitation of copper salts in the medium was observed only at pH 5.5. Increased levels of superoxide dismutase (SOD) activity were observed in copper-treated cells and which persisted after 20 subsequent inocula in a medium without added metal. On the contrary, catalase activity was not stimulated by copper treatment and, hence, not correlated with SOD levels. The mechanism of copper resistance, therefore, probably involves a persistent induction of SOD, but not of catalase, and it is strongly pH-dependent. |
8043986 | Mössbauer spectra of the heme peptide (HP) 1-50 and the heme peptide:non-heme peptide (NHP) non-covalent complex 1-50:51-104 derived from cytochrome c: evidence for cytochrome c iron site solvation in aqueous solution. | Mössbauer spectroscopic studies on a heme peptide (HP) derived from cytochrome c and on the HP recombined non-covalently with the remaining cleaved section are reported. The results suggest that the environment of the heme site in the known crystal structure of cytochrome c may differ in detail from the environment of the heme in the working protein. |
8043985 | Association of iron with colorectal cancer. | Many studies indicate that animals and humans burdened with excess iron are at increased risk of neoplasia at various sites. This review focuses on inquiries that involve iron and colorectal cancer. Relevant studies reported in the past decade are briefly described and evaluated. The studies in animal models and in relatively large groups of humans point to a positive association of excessive iron with colorectal oncogenesis. Phytic acid, a chelator of iron and zinc, may be useful in withholding iron from the carcinogenic process. Sufficient evidence is available to justify construction of long-term prospective studies in humans in which would be monitored (i) levels of iron and phytate intake, (ii) serum transferrin iron saturation and ferritin, (iii) fecal levels of iron and hydroxyl radicals, and (iv) appearance of colorectal polyps, adenomas and carcinomas. |
8043983 | Treatment of a patient with malignant mesothelioma with interferon-alpha 2 based on in vitro sensitivity tests. | The case of a 70-year-old patient with an epithelial mesothelioma is presented. The patient suffered from dyspnea due to a right-sided recurrent hemorrhagic effusion. Cytological analysis of the effusion revealed marked lymphocytosis and tumor cells, some of them multinucleated with prominent nucleoli. Open lung biopsy revealed nodular thickening of the diaphragmatic, visceral, and parietal pleura; histological examination of biopsies detected intravascular growth of tumor cells. Immunocytochemical characterization of cultured tumor cells and the biopsy specimens showed positive staining to vimentin and cytokeratin, but negative reaction with antibodies against epithelial membrane associated antigen, leukocyte common antigen, van Willebrand factor, and neurofilament. Hence, the tumor was classified as malignant mesothelioma. In vitro, interferon-alpha 2 produced a dose-dependent inhibition of proliferation in the cultured mesothelioma cells. Two weeks after initiation of interferon-alpha 2 treatment the patient improved and the pleural effusion vanished. |
8043984 | The pathogenesis of HLA-B27 associated arthritis: lessons from the B27 crystal. | The most remarkable association between a major histocompatibility complex antigen and disease susceptibility--HLA-B27 and seronegative spondyloarthropathies, particularly ankylosing spondylitis--was discovered 20 years ago. During the two intervening decades advances in basic immunology and molecular biology have not only revealed the biosynthesis and structure of HLA-B27 but also given clues to the basic function of this molecule, the presentation of allele-specific peptides to CD8+ cytotoxic T cells. The recently reported three-dimensional structure of HLA-B27 and the identification of self-peptides bound to this major histocompatibility complex class I antigen can be viewed as a landmark in the understanding of the pathogenic role of HLA-B27. Based on crystallographic evidence, a peptide-binding motif can be postulated that should allow identification of HLA-B27 complexed peptides which may trigger an immune reaction causing arthritis. |
8043979 | Ventricular fibrillation related to coronary spasm in patients without significant coronary or other structural heart disease. | We present three patients without significant coronary or other structural heart disease who were resuscitated after ventricular fibrillation attributed to coronary spasm. Angina pectoris was present in two of the cases and silent myocardial ischemia in the third. All patients were given calcium antagonists at discharge. A defibrillator was also implanted in the patient with silent myocardial ischemia because further episodes of ischemia would probably have occurred without premonitory symptoms. Coronary spasm might be a mechanism of ventricular fibrillation in patients without significant structural heart disease. Diagnostic tests should therefore be performed to confirm or exclude coronary spasm in such cases. The implantation of an automatic defibrillator seems justified in selected patients with documented coronary spasm, silent myocardial ischemia, and associated sustained ventricular tachyarrhythmia, although prospective studies are not yet available. |
8043977 | Fenofibrate improves postprandial chylomicron clearance in II B hyperlipoproteinemia. | In 11 patients with IIB hyperlipoproteinemia we studied fasting lipids, lipoproteins, lipoprotein-modifying enzymes, and postprandial lipid metabolism after a standardized oral fat load supplemented with vitamin A before and 12 weeks after treatment with fenofibrate, a third-generation fibric acid derivative. Fasting plasma cholesterol, triglycerides, low-density lipoprotein cholesterol decreased significantly (P < 0.05, P < 0.01, P < 0.01), high-density lipoprotein subfraction 3 cholesterol increased significantly (P < 0.05), and high-density lipoprotein subfraction 2 cholesterol remained unchanged. Postprandial lipemia, i.e., the integrated postprandial triglyceride concentrations corrected for the fasting triglyceride level, and postprandial chylomicron concentrations, as assessed by biosynthetic labeling of chylomicrons with retinyl palmitate, decreased by 40.6% and 60.1% (P < 0.05; P < 0.05), respectively. The activity of lipoprotein lipase (LPL) increased by 33.6% (P < 0.05); the increase in LPL during fenofibrate treatment was positively correlated with the increase in high-density lipoprotein cholesterol (r = 0.84; P < 0.005). Hepatic lipase and cholesteryl ester transfer protein mass and activity remained unchanged. We conclude that lipid-lowering therapy with fenofibrate ameliorates fasting and, more profoundly, postprandial lipoprotein transport in hypertriglyceridemia by curbing postprandial triglyceride and chylomicron accumulation, at least in part, through an increase in LPL activity. |
8043978 | Giant intrasellar aneurysm presenting with panhypopituitarism and subarachnoid hemorrhage: case report and literature review. | A 52-year-old woman was admitted to our hospital presenting with subarachnoid hemorrhage, left ophthalmoplegia, and right hemiparesis. Previous symptoms and signs suggested the presence of panhypopituitarism. A giant intracranial aneurysm of the internal carotid artery, diagnosed by magnetic resonance imaging, showed the characteristic flow void phenomenon with black appearance. Analysis of endocrine function disclosed panhypopituitarism and hyperprolactinemia. After proximal balloon occlusion of the aneurysm, diabetes insipidus developed. Pituitary function reassessed 6 months after initial admission confirmed anterior and posterior hypopituitarism and hyperprolactinemia. Possible mechanisms are discussed. A review of the literature on pituitary dysfunction caused by carotid artery aneurysms discloses that the pituitary-gonadal axis is the most frequently involved (67.5% of cases), followed by the pituitary-adrenal axis (48.6%) and the pituitary-thyroid axis (40.5%). These frequencies are very similar to those described in other types of hypopituitarism. |
8043976 | Endothelin-1 immunoreactivity in plasma is elevated in HIV-1 infected patients with retinal microangiopathic syndrome. | Endothelin-1 is a recently identified cytokine with potent vasoconstrictor activity which is associated with various diseases involving blood vessels. HIV-1 related retinal microangiopathic syndrome is a frequent finding in patients with AIDS or AIDS-related complex, presenting predominantly with retinal cotton-wool spots. We investigated 55 HIV-1 infected patients by ophthalmoscopy and for endothelin-1 immunoreactivity in plasma and an additional 76 HIV-1 infected patients only for endothelin-1 levels. For reference values 13 age-matched healthy subjects were studied. In 18 of 55 patients (33%) investigated ophthalmoscopically we found evidence of microangiopathic syndrome. Overall, the mean endothelin-1 immunoreactivity in plasma of HIV-1 infected patients was significantly elevated as compared to controls (4.28 +/- 3.62 versus 2.72 +/- 0.67 fmol/ml, P < 0.0001). HIV-1 infected patients with retinal microangiopathic syndrome had significantly higher plasma levels of endothelin-1 immunoreactivity (4.59 +/- 1.38 fmol/ml) compared to HIV-1 infected patients without microangiopathic syndrome (3.18 +/- 1.64 fmol/ml, P = 0.003). Correlation analysis revealed that endothelin-1 immunoreactivity in plasma had no significant association with disease progression, CD4 cell count, beta 2-microglobulin, neopterin, or age. Endothelin-1 immunoreactivity in plasma was correlated exclusively with retinal microangiopathic syndrome in one or both eyes (r = 0.45, P = 0.0006) and with the number of cotton-wool spots (r = 0.50, P = 0.0001). In conclusion, HIV-1 related retinal microangiopathic syndrome is associated with elevated plasma levels of endothelin-1. By virtue of its potent vasoconstrictor activity endothelin-1 may be involved in the pathogenesis of HIV-1 related vascular disease. |
8043975 | AIDS-free survival and overall survival in HIV infection: the new CDC classification system (1993) for HIV disease and AIDS. | The clinical history of 1538 HIV positive patients was analyzed on the basis of the new CDC classification system of HIV disease and AIDS. This classification system combines three CD4 cell categories (1, 2, and 3) with three clinical categories (A, B, and C) into nine subgroups A1-C3. We examined the overall survival for all subgroups and the AIDS-free survival for subgroups A1-B3. AIDS-free survival for patients in subgroups A1, A2, and B1 was considerably longer than survival in patients from subgroups A3, B2, and B3 (P < 0.0001). According to these findings, the new CDC classification system could be simplified into three stages, stage I and II comprising the above mentioned six subgroups, and stage III comprising clinical AIDS defining categories C1, C2, and C3. These three stages correspond to different periods in the management of HIV positive patients, i.e., period of observation, period of prophylaxis, and period of treatment. |
8043974 | Low-dose prednisolone/chlorambucil therapy in patients with severe membranous glomerulonephritis. | Because of the high rate of spontaneous remission, treatment of membranous nephropathy with prednisolone and chlorambucil is still controversial. The aim of this study was to give this therapy only to those patients at risk of developing renal insufficiency and to test the efficacy of a low-dose therapeutic regimen. Seventeen patients with more than 10 g protein excretion per day (mean 16.9) and/or a deterioration in renal function (mean serum creatinine, 162 mumol/l) were included. Serum total protein, serum lipids, proteinuria, serum creatinine, and blood pressure were measured, along with the diuretic and antihypertensive medication. The observation time before the start of treatment was 27 +/- 27 months. Steroids were given during months 1, 3, and 5 (methylprednisolone 3 x 500 mg intravenously) prednisolone 0.5 mg/kgBW daily per os for 1 week, then tapered by 0.1 mg/kg BW/week for 1 month). Chlorambucil was given during months 2, 4, and 6 at a dose of 0.12 mg/kgBW daily. At the end of treatment proteinuria had significantly decreased (mean of all patients, 7.8 +/- 1.4 g/d) in all patients. Six months after the end of treatment proteinuria was significantly lower than at baseline in 14 of 17 patients. Hypoproteinemia and hyperlipidemia had improved; diuretic and antihypertensive medication were reduced. Elevated serum creatinine decreased in 7 of 9 patients (pretreatment, 227 +/- 39 mumol/l; 6 months, 176 +/- 28 mumol/l). Nonresponders with respect to serum creatinine responded with respect to proteinuria. Regarding adverse effects, two patients complained of dyspepsia while taking steroids; during chlorambucil treatment two patients experienced nausea and lack of appetite, and one developed leukopenia (1600/microliters).(ABSTRACT TRUNCATED AT 250 WORDS) |
8043973 | Elastinolytic activity of alveolar macrophages in smoking-associated pulmonary emphysema. | Current concepts of pathomechanisms leading to acquired emphysema suggest that alveolar macrophages (AM) activated by cigarette smoking may cause an elastase/antielastase imbalance localized to the microenvironment formed by phagocytes and lung tissue. A functional cell assay was used to evaluate the cell-associated elastinolytic activity of AM. AM were obtained by bronchoalveolar lavage from patients with emphysema and from patients with non obstructive chronic pulmonary diseases (non-COPD) and cultured under serum-free conditions in direct contact with 3H-labeled elastin particles. Elastinolytic activity was calculated from the released radioactivity in culture supernatants and expressed as micrograms of 3H-elastin degraded x 10(-5) AM x 72 h-1. AM of patients with emphysema had significantly higher elastinolytic activity compared to that of non-COPD patients (median: 10.8 versus 4.1 micrograms; P < 0.01). Further differentiation of patients revealed the lowest median activity in sarcoidosis (2.3 micrograms). In respect to smoking habits there was a major difference between smokers with emphysema degraded more than twice the amount of elastin than smokers in the non-COPD group (median:11 versus 3.9 micrograms, P = 0.01). From these data we conclude that AM-derived elsatinolytic proteases may be involved in the destruction of lung elastin, which is thought to be the key event occurring in the pathogenesis of pulmonary emphysema. |
8043972 | Chronic continuous infusion of nicotine increases the disappearance of choline acetyltransferase immunoreactivity in the cholinergic cell bodies of the medial septal nucleus following a partial unilateral transection of the fimbria fornix. | Previous studies have demonstrated that chronic continuous nicotine treatment via minipumps partially protects against mechanically induced degeneration of the nigrostriatal dopamine neurons in the male Sprague-Dawley rat. In the present study we investigated how a 4-week continuous infusion with (-)-nicotine via minipumps implanted subcutaneously in the male Sprague-Dawley rat (0.125 mg/kg-1 h-1) influences the anterograde and retrograde changes occurring in the septohippocampal cholinergic neurons following a unilateral transection of the fimbria fornix. Choline acetyltransferase and acetylcholinesterase immunocytochemistry was performed in combination with computer-assisted morphometry and microdensitometry. Measurements of choline acetyltransferase enzyme activity was performed in the dorsal hippocampus. The chronic nicotine infusion significantly increased the disappearance of the choline acetyltransferase immunoreactive nerve cell area within the medial septal nucleus of the lesioned side. However, the disappearance of the acetylcholinesterase immunoreactive nerve terminals within the dentate gyrus (molecular layer) and of choline acetyltransferase enzyme activity within the dorsal hippocampus was not found to be influenced by the chronic nicotine infusion. Thus, chronic infusion of (-)-nicotine does not appear to exert any protective activity on mechanically injured septohippocampal cholinergic neurons but may instead increase their dysfunction. In comparison with the dopaminergic neurons it may therefore be that the continuous chronic nicotine exposure does not lead to sufficient desensitization of the nicotinic cholinoceptors of the cholinergic neurons to reduce the chronic influx of sodium and calcium ions via the nicotinic ion channels and thus intraneuronal calcium levels and energy demands.(ABSTRACT TRUNCATED AT 250 WORDS) |
8043971 | Heinrich Wieland--prize lecture. Transport of proteins across mitochondrial membranes. | The vast majority of proteins comprising the mitochondrion are encoded by nuclear genes, synthesized on ribosomes in the cytosol, and translocated into the various mitochondrial subcompartments. During this process proteins must cross the lipid membranes of the mitochondrion without interfering with the integrity or functions of the organelle. In recent years an approach combining biochemical, molecular, genetic, and morphological methodology has provided insights into various aspects of this complex process of intracellular protein sorting. In particular, a greater understanding of the molecular specificity and mechanism of targeting of mitochondrial preproteins has been reached, as a protein complex of the outer membrane which facilitates recognition and initial membrane insertion has been identified and characterized. Furthermore, pathways and components involved in the translocation of pre-proteins across the two mitochondrial membranes are being dissected and defined. The energetics of translocation and the processes of unfolding and folding of proteins during transmembrane transfer are closely linked to the function of a host of proteins known as heat-shock proteins or molecular chaperones, present both outside and inside the mitochondrion. In addition, the analysis of the process of folding of polypeptides in the mitochondrial matrix has allowed novel and unexpected insights into general pathways of protein folding assisted by folding factors. Pathways of sorting of proteins to the four different mitochondrial subcompartments--the outer membrane (OM), intermembrane space, inner membrane (IM) and matrix--are only partly understood and reveal an amazing complexity and variation. Many additional protein factors are involved in these latter processes, a few of which have been analyzed, such as cytochrome c heme lyase and cytochrome c1 heme lyase, enzymes that catalyze the covalent addition of the heme group to cytochrome c and c1 preproteins, and the mitochondrial processing peptidase which cleaves signal sequences after import of preproteins into the matrix. Thus, the study of transport of polypeptides through the mitochondrial membranes does not only contribute to the understanding of how biological membranes facilitate the penetration of macromolecules but also provides novel insights into the structure and function of this organelle. |
8043969 | [Rehabilitation program for assurance of occupational capacity]. | This article concerns the specific Federal German regulations governing payment of rehabilitation costs by the statutory insurance body within the framework of the legally prescribed pension fund insurance. Rehabilitation measures covered by this legislation should be taken as soon as initial health disorders are noticed that do not yet seriously hamper the personal and professional performance of the relevant individual. The number of persons to be treated for rehabilitation is determined inter alia by job factors that are injurious to health as well as by factors representing the individual's health disposition and body constitution. Such health-preserving measures are scheduled for a duration of 3 weeks. They have been conceived under group dynamic aspects and consists of a complex holistic health schema involving motion therapy and health education. The object of such preventive rehabilitation is to forestall any major disorders that may lead to premature loss of gainful employment ability, taking job stress into consideration and paying close attention to any signs of a possibly incumbent disabling disease. |
8043968 | [Molecular epidemiology of Neisseria gonorrhoeae: effect of sex and sexual orientation on the distribution of gonococcal types]. | Auxotype/serovar (A/S) classification enables precise characterisation of Neisseria gonorrhoeae. In the present study we evaluated whether sex and sexual preference of the patient influence the auxotype/serovar class of the infecting gonococcal strain. In male patients prototrophic/IB-3 was the most frequently isolated A/S class. By contrast, in female patients the A/S class (P)AH(U)/IA-1/2 was significantly (p < 0.005) more frequently isolated than in male patients. Analysis of our data according to sexual preference of the patients showed that in heterosexual patients the two mentioned A/S classes were leading, whereas in homo- and bisexual patients A/S classes prototrophic/IB-2 (p < 0.0001) and Pro/IB-2/16 (p < 0.0001) were isolated significantly more often. Our data are a strong indication that the host environment is also responsible for the selection of N. gonorrhoeae strains with certain typing characteristics. |
8043967 | [Medical and non-medical assistance for suicide]. | Assistance to suicide can only be accepted ethically and juristically if the decision to commit suicide is based on a responsible, undisturbed freedom of decision-making. However, in a selection of the patients willing to commit suicide this freedom is restricted due to mental illness or other psychiatric disorders. In such cases doctors as well as laymen are obliged to help the patient to survive. Some problems may arise from the fact that medical laymen are frequently incompetent in distinguishing between mentally normal and disturbed states. |
8043966 | [Caries incidence, caries morbidity and degree of restoration in elementary school students of the Rems-Murr district--a comparative study after 3 years]. | Based on an epidemiological caries study conducted in 1988, 1229 children of primary schools in the Rems-Murr-region were examined during autumn 1991 under identical conditions. The average DMF-T values vary from 0.2 for the children of 6 years of age to 1.7 for those of 10 years of age. Compared to 1988 and depending on age a caries reduction between 10 and 46% in permanent teeth was determined. In same period the percentage of caries-free children (df-t and DMF-T = 0) has clearly increased and the number of those who needed treatment in permanent teeth has been reduced by 50%. Especially in permanent teeth the state of treatment (MF-T:DMF-T x 100) has been improved considerably and vary now from 31 to 75% depending on age. Although different factors are responsible for the recent caries decline, the intensification of health education programmes probably plays a prominent role. |
8043965 | [Comparison of the body burden of the population of Leipzig and Munich with the heavy metals cadmium, lead and mercury--a study of human organ samples]. | In the former GDR it was almost impossible to perform studies on environmental pollution. Therefore, a short time after the opening of the German interior border the authors started an investigation on the heavy metal burden of humans in the former District of Leipzig (Saxonia). In 1990/91 tissues from 57 deceased were collected from this region. The concentrations of cadmium were determined in specimens from the liver and renal cortex, of mercury in liver, renal cortex and grey matter of the cerebrum and of lead in samples of the pelvic bone and the cortical part of the femur. After sample pretreatment, the heavy metal concentrations were determined by GF-AAS or CV-AAS. The results were compared with studies recently performed by the authors in the region of Munich (southern Bavaria, FRG) and with values from the literature. It was found that the burden with cadmium was similar in both regions, whereas on the average, the bone lead concentrations in Leipzig were 10 times (!) higher than in Munich. Considering dental amalgam as main factor for the burdening with inorganic mercury, the mercury concentrations in the liver and the renal cortex were of the same order of magnitude in both regions. In contrast to this, significantly higher mercury concentrations were found in the brain samples from Leipzig than from Munich. Possible negative health effects of these elevated lead and mercury burden in the Leipzig area are discussed. |
8043964 | [Public health evaluation of (hazardous) substances in soil--concept of the AGU and Department of "Tolerable (Hazardous) Substance Concentrations in Soil" for metals]. | Up to now no uniform procedure and no generally accepted values exist for health evaluation of pollutants in soil. Aim of the working group for environmental hygiene (AGU) of the Bavarian Ministry of Labour and Social Order, Family, Women and Health is to propose health-based procedures and values for assessment, in consideration of existing concepts and regulations. Basis for health evaluation is the existence of appropriate soil investigations. This refers to the sampling scheme (sampling depth, sampling site and manner, number and representativity of samples) as well as sample preparation and analysis. The "still tolerable pollutant concentration in soil" (TSKB) is supposed to mark a threshold which separates a range of tolerable pollutant concentration from a range where soil-related measures are indicated. Basis for determination of a TSKB-value is the estimation of the average uptake of the respective substance via air, drinking water and food. From this the average level of a tolerable dosis without health risk by regular long-term uptake by humans is calculated. From the remaining portion of tolerable uptake the TSKB-value for the additional pathway of uptake by soil is derived. The estimations are representatively performed for 3-year old children, because small children are especially endangered by uptake of polluted soil. TSKB-values were determined by this procedure for the metals As, Cd, Cr, Cu, Hg, Ni, Pb, Zn and compared with assessment criteria and values of other working groups. |
8043963 | [Implementation of the psychiatric personnel regulation--an intermediate-term evaluation]. | The new German Psychiatry Personnel Regulations were enforced in 1991. The aim was to set a standard for performance-adapted optimised personnel calculation for all professions taking part in stationary care and to initiate structural changes in psychiatric institutions. In general psychiatry, geronto-psychiatry, and addiction diseases, patients are classified in different categories according to the degree of disease and resulting therapeutic effort by the team taking part in therapy. In this manner personnel requirements are calculated prospectively in terms of working minutes. Realisation in Schleswig-Holstein is based on general agreements that allow evaluation, testing, and quality assurance by a graduated instrumentarium basing on valid data. A differentiated interventional management has been agreed upon. It will act in case of conflicts caused by the clinical classifications. Categorisation shows a clear trend towards classifying patients in the mandatory intensive care groups A2, S2 and G2. Correspondingly fewer patients are classified as requiring "standard treatment" and "treatment for severe and multiple sickness". This development is mainly supported by large specialised clinics and institutions with less than 50 beds. The acute-case departments of houses for central care show largely stable categorisation data during the 1 1/2 years of the survey. To evaluate the changes and trends a catalogue of structural points of view serves to verify the structural changes. Thus, criteria of quality are defined that contribute to an evaluation of the realisation of the new Personnel Regulations and support quality planning and management of the clinics.(ABSTRACT TRUNCATED AT 250 WORDS) |
8043962 | [Elder care in nursing homes during national socialism in Germany]. | The situation of the elderly during the Third Reich has hitherto been neglected by research. This paper deals with the living conditions and the fate of the aged in institutional homes in Saxony. Those no longer able to care for themselves were subjected to the aggressive social and military goals pursued by the National Socialists and were victimized in the organisation of medical care. Many conditions contributed to the destruction of their lives: not only the emptying of homes for the elderly to make room for military hospitals, disorienting relocation programmes, and the murderous "T4" programme, but also the death of children during the war, the destruction of property and the loss of a home due to forced dislocation. |
8043961 | [The relevance of health status for nursing home admission of elderly patients]. | The article is based on a longitudinal study examining the risk of institutionalization in old age, especially with reference to the health status. According to the results, chronic disease only in interaction with old age has a significant impact on institutionalization. Other interactions for example between health status and housing conditions or between health status and marital status were not found. However, the age impact on institutionalization is not fully explained by other factors such as health condition. Altogether, healthy elderly people become institutionalized less often and later than elderly people who are either chronically ill or physically disabled or handicapped. |
8043952 | Efficient identification and regional positioning of YAC and cosmid clones to human chromosome 21 by radiation fusion hybrids. | The use of integrated mapping strategies involving bacterial, yeast, and rodent cells as hosts simplifies the construction of maps, which combine long-range order, high resolution, and easy access to the cloned DNA. Radiation-fusion hybrids offer a specially powerful long-range mapping system for human chromosomes. We describe here techniques for establishing a radiation-fusion hybrid map of Chromosome (Chr) 21q and its integration with local information on YAC and cosmid positions. |
8043953 | The Portable Dictionary of the Mouse Genome: a personal database for gene mapping and molecular biology. | The Portable Dictionary of the Mouse Genome is a database for personal computers that contains information on approximately 10,000 loci in the mouse, along with data on homologs in several other mammalian species, including human, rat, cat, cow, and pig. Key features of the dictionary are its compact size, its network independence, and the ability to convert the entire dictionary to a wide variety of common application programs. Another significant feature is the integration of DNA sequence accession data. Loci in the dictionary can be rapidly resorted by chromosomal position, by type, by human homology, or by gene effect. The dictionary provides an accessible, easily manipulated set of data that has many uses--from a quick review of loci and gene nomenclature to the design of experiments and analysis of results. The Portable Dictionary is available in several formats suitable for conversion to different programs and computer systems. It can be obtained on disk or from Internet Gopher servers (mickey.utmen.edu or anat4.utmen.edu), an anonymous FTP site (nb.utmem.edu in the directory pub/genedict), and a World Wide Web server (http://mickey.utmem.edu/front.html). |
8043951 | Assignment of rat Jun family genes to chromosome 19 (Junb), chromosome 5q31-33 (Jun), and chromosome 16 (Jund). | By means of somatic cell hybrids segregating rat chromosomes, we determined the chromosome localization of three rat genes of the Jun family: Junb (Chr 19), Jun (=c-Jun) (Chr 5) and Jund (Chr 16). The Jun gene was also localized to the 5q31-33 region by fluorescence in situ hybridization. These rat gene assignments reveal two new homologies with mouse and human chromosomes, and provide a new example of synteny conserved in the human and a rodent species (the mouse), but split between the two rodent species. |
8043950 | Molecular map of chromosome 19 including three genes affecting bleeding time: ep, ru, and bm. | The mouse ruby eye (ru) and pale ear (ep) pigment dilution genes cause platelet storage pool deficiency (SPD) and prolonged bleeding times. The brachymorphic (bm) gene, in addition to causing skeletal abnormalities, is also associated with prolonged bleeding times. All three hemorrhagic genes are found within 10 cM on Chromosome (Chr) 19. In this study, 15 microsatellite markers and five cDNAs, spanning 21 cM of Chr 19, were mapped in relation to the bm, ep, and ru genes in 457 progeny of an interspecific backcross utilizing the highly inbred strain PWK derived from the Mus musculus musculus species. Several markers were found to be closely linked to the three genes and should be useful as entry points in their eventual molecular identification. |
8043949 | Genetic mapping of 40 cDNA clones on the mouse genome by PCR. | We recently proposed a new PCR-based genetic marker assay for the mouse genome that exploits sequence differences in the 3'-untranslated region (UTR) of cDNAs between different mouse strains, called "biallelic polymorphic expressed sequence tags (bESTs)." The specific use of 3'-UTR has several advantages: (1) frequent sequence polymorphism between different mouse strains, (2) most commonly uninterrupted by introns, (3) usually unique sequence even among closely related gene family members. In this paper, we identify additional genetic loci defined by bEST and determine their location on the mouse genetic map by using interspecific backcross mapping panels between C57BL/6J and Mus spretus. Of 136 markers tested, 86 produced unique PCR products from C57BL/6J and M. spretus genomic DNAs. We then sequenced these 86 PCR products from C57BL/6J and M. spretus and found that 59 markers have sequence polymorphisms. Of these, we mapped 36 by restriction fragment length polymorphism (RFLP) of the PCR products and 4 by length polymorphism (LP) of the PCR products. We discuss the possibility of a large-scale application of this method for cDNA mapping. |
8043948 | Mouse rump-white mutation associated with an inversion of chromosome 5. | The rump-white (Rw) mutation in the mouse was previously mapped as part of a cluster of spotting genes on Chromosome (Chr) 5 that includes the dominant spotting (W) and patch (Ph) loci. Recent studies have shown that the W locus encodes the KIT tyrosine kinase cell surface receptor and that Ph is a deletional mutation encompassing the platelet-derived growth factor receptor alpha subunit (Pdgfra) gene. However, the molecular basis of the Rw mutation remains to be established. We have analyzed an interspecific Mus spretus backcross segregating Rw and several loci proximal and distal to the W/Ph/Rw region to study the basis of this mutation. These studies indicated that loci within the En2 to Kit region of the chromosome do not recombine with one another even though they have been separated in other mapping studies presented here and elsewhere. We conducted a series of fluorescent in situ hybridization (FISH) studies with genomic probes to En2, Msx1, D5Buc1, and Kit to compare the physical order of these loci on the Rw and wild-type chromosomes. The Kit locus mapped to approximately the same region on both chromosomes of the Rw heterozygotes, while the positions of En2, Msx1, and D5Buc1 were reversed on the two chromosomes. Taken together, both the genetic and physical mapping data establish that the Rw mutation is associated with an inversion involving loci in the proximal region of Chromosome 5. |
8043947 | The mapping of transgenes by fluorescence in situ hybridization on G-banded mouse chromosomes. | A highly sensitive method for the mapping of transgenes and other genes in the mouse genome is described. This technique combines high-resolution G-banding and fluorescence in situ hybridization (FISH) with either biotin/avidin-FITC or digoxigenin-anti-digoxigenin-FITC, the latter being the more sensitive. Banding patterns are obtained with trypsin/Giemsa-treated slides, and sensitivity is greatly increased by the use of mouse Cot-1 DNA. With this protocol, four different 14.5-kb human Cu/Zn-superoxide dismutase transgene insertions ranging in copy number from 2 to 8 have been localized to four different mouse chromosomes. The utility and sensitivity of this procedure were verified with a Chromosome (Chr) 16-specific cosmid probe, H22, as well as with the mapping of a high-copy-number human beta-amyloid/A4 transgene. |
8043946 | The ter primordial germ cell deficiency mutation maps near Grl-1 on mouse chromosome 18. | A single recessive gene, ter (teratoma), causes germ cell deficiency and a high incidence of congenital testicular teratomas in the 129/Sv-ter strain of the mouse. Linkage analyses between the ter gene and 36 marker genes of 19 chromosomes were performed with matings between the C57BL/6J-ter congenic strain and four inbred strains. Results showed that the ter gene was linked to D18Mit9, D18Mit14, and D18Mit17 on Chromosome (Chr) 18. Gene order estimated on the basis of recombination distance (in centimorgans) was [centromere-D18Mit14-5.1 (cM)-ter-0 (cM)-D18Mit17-23.8 (cM)-D18Mit9]. D18Mit17 is the microsatellite DNA of the Grl-1 (glucocorticoid receptor-1) locus. We conclude that the ter gene is closely linked to Grl-1 on Chr 18 and is a new mutation involving the developmental modification of primordial germ cells in mice. |
8043945 | Present status of the ovine gene map (Ovis aries); comparison with the bovine map (Bos taurus). | The status of the sheep map to the end of June 1993 is presented. Mapping information is available for a total of 107 loci comprising 16 anonymous DNA segments. This is an increase of 66 loci since 1990. No loci have been mapped on 10 of the 26 autosomes. Comparison of the cattle (350 loci) and sheep maps confirms their close evolutionary and genetic relationship and will reduce the effort required for their gene mapping. |
8043944 | Pimobendan. A review of its pharmacology and therapeutic potential in congestive heart failure. | Pimobendan is a novel cardiotonic vasodilator (inodilator) which derives its inotropic activity from a combination of phosphodiesterase III inhibition and sensitisation of myocardial contractile proteins to calcium. The acute haemodynamic benefits of pimobendan (2.5 to 10mg orally; 5 to 10mg intravenously) seen in patients maintained on conventional diuretic, digitalis and vasodilator therapy for chronic heart failure (increases in cardiac output and stroke volume, and reductions in left ventricular preload and afterload) persisted on short term (1 month) therapy, and showed only limited evidence of attenuation on longer term (6 months) oral therapy with pimobendan 2.5 or 5mg twice daily. Adjunctive therapy with pimobendan 1.25 to 5mg twice daily for periods of 3 to 6 months improved exercise tolerance on symptom-limited exercise testing, New York Heart Association (NYHA) functional class, and quality of life, and additionally reduced the need for hospitalisation in patients with moderate to severe chronic heart failure. Pimobendan appears to be well tolerated at therapeutic doses (1.25 to 5mg twice daily) in patients with chronic heart failure, and preliminary indications suggest that it is largely devoid of the proarrhythmic effects of classical phosphodiesterase III inhibitors. Although information regarding the long term effects of pimobendan on mortality is currently lacking, the drug nevertheless shows potential benefit as an adjunctive therapy in patients with chronic heart failure. |
8043943 | Acquired immunodeficiency syndrome in the elderly. | Recent data from the US show that since 1990 the number of paediatric patients with AIDS is decreasing while the number of patients with AIDS over age 50 years is increasing. To date, little attention has been given to understanding AIDS risk-taking behaviours, clinical presentations, and therapeutic needs of middle-aged and older HIV-infected individuals. Older HIV-infected individuals deteriorate more rapidly than younger patients due to an accelerated loss of CD4+ helper T cells. Despite recognised age-related physiological differences between young and elderly individuals, scant information about drug optimisation for the treatment of AIDS in older individuals is available. More data need to be collected about this group of AIDS patients, and appropriate treatment strategies designed for their special needs. |
8043941 | Potential role of oral anthracyclines in older patients with cancer. | Two anthracycline analogues, idarubicin and menogaril, have acceptable bioavailability via the oral route of administration. Encouraging antitumour activity of oral idarubicin has been reported in breast cancer, non-lymphocytic leukaemia, non-Hodgkin's lymphoma and myeloma. The outlook for menogaril is less clear, given the modest antitumour activity reported so far. Although the oral formulations of idarubicin and menogaril remain investigational, they represent a step forward in the direction of developing new active anticancer drugs with oral bio-availability. Further prospective studies of the orally-active anthracyclines in elderly patients with cancer are justified. These studies should address specific issues such as optimal dosage regimens as a function of 'physiological age', and quality of life. |
8043942 | Insulin resistance and hypertension in the elderly. Optimal drug therapy. | Numerous trials have demonstrated the negative effects of some antihypertensive drugs upon glucose handling. Such findings seem particularly interesting in aged hypertensive patients who are also insulin resistant and affected by physiological changes in the renal and cardiovascular systems. It appears that calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors are the most appropriate drugs to lower blood pressure in aged insulin-resistant hypertensive patients. All calcium channel blockers studied have displayed similar metabolic effects, while among the ACE inhibitors studied, lisinopril was associated with the best metabolic responses. beta-Blockers and thiazide diuretics have strong negative effects on glucose handling. Further studies are needed in order to investigate the metabolic effects of alpha 1-antagonists in aged patients with insulin resistance and hypertension. |
8043940 | Prevention and treatment of urinary catheter-related infections in older patients. | The elderly population is more likely to have urinary catheters used than younger populations. Most patients with short term indwelling catheters (those in place less than 30 days) will be residents of acute care institutions. The frequency of catheter-acquired bacteriuria is greater with longer durations of catheterisation, female gender, failure to maintain a closed drainage system, and in patients not receiving systemic antimicrobials. Systemic antimicrobials given within 48 hours of catheter removal decrease the incidence of urinary infection, but are not currently recommended because of concerns with antimicrobial resistance. Interventions such as topical meatal antimicrobials, disinfectants added to the urinary drainage bag, antimicrobial coatings for catheters, and antimicrobial irrigation have not been shown to decrease the incidence of infection. Asymptomatic bacteriuria should not be treated while the catheter remains in place. However, catheter-acquired bacteriuria should probably be treated following catheter removal. Long term indwelling catheters are most frequently used in elderly individuals resident in long term care institutions. These individuals are always bacteriuric, usually with a complex polymicrobial flora. There are no clinical benefits of treatment of asymptomatic bacteriuria in such persons. In fact, treatment will promote the emergence of resistant organisms. The optimal management of symptomatic infection has not been defined. |
8043939 | Management of older adults with hypercholesterolaemia. | Although the strength of total cholesterol levels as a relative risk factor for coronary heart disease (CHD) declines with age, the prevalence of CHD increases dramatically with age. Data from cholesterol treatment trials, although sparse in older adults, suggest that dyslipidaemia treatment has the potential to prevent CHD. In particular, dyslipidaemia treatment appears to be most beneficial in older adults with a history of CHD or who have several other CHD risk factors. Dyslipidaemia screening should be selective in the elderly, reserved for those whose health status would be amenable to nutritional or pharmacological therapy, and in whom several CHD risk factors or a history of CHD are present. Since high density lipoprotein cholesterol (HDL) levels retain their inverse association CHD in old age, cholesterol subfractions should be measured in persons being screened in order to adequately assess the severity of dyslipidaemia. Treatment decisions should be guided by the patient's dyslipidaemic class, which is determined by the cholesterol subfractions and serum triglycerides (TG). As in younger persons, nutritional therapy remains the first step in dyslipidaemia management in high risk, nondebilitated older adults. An array of cholesterol modifying medications are available which vary widely in treatment effects, adverse effects and cost. Extra care needs to be taken in prescribing these agents in older adults because of greater potential for adverse effects and interactions with other medications. The cost-effectiveness of pharmacological treatment decreases with age and increases with the severity of dyslipidaemia, a history of CHD, or the presence of multiple CHD risk factors. When comparing elderly to middle-aged adults, the relative cost-effectiveness of different cholesterol-lowering medications may be altered due to age-related changes in therapeutic efficacy and adverse effects. |
8043937 | The red cell membrane and invasion by malarial parasites. | The red cell membrane with its bilipid layer, integral membrane proteins (especially the GPs and band 3), and the red cell skeleton pose a formidable barrier for the malarial parasite to overcome during invasion. Invasion is an ordered and sequential process, indicating a highly complex and specific process involving numerous molecular interactions. For P. vivax and P. knowlesi infections the Duffy glycoprotein seems to be a specific requirement in invasion. For P. falciparum the GPs, and especially the N-acetyl neuraminic acid linked in an alpha 2-3 configuration on them, appear to act as specific ligands although some strains of P. falciparum may use alternate ligands for invasion. The parasite enters the red cells within an invagination continuous with the red cell bilipid layer, the parasitophorous vacuole membrane, and recent evidence would indicate that this membrane is largely of parasite origin. The numerous occasions in which the red cell needs to deform during invasion indicates that membrane deformability could be an important factor in determining invasion, but the dissociation of invasion and deformability as induced by a number of reagents would not support this contention. Instead it is suggested that reagents which modify invasion may be acting via alterations in red cell or parasite protein phosphorylation or dephosphorylation. |
8043936 | Congenital dyserythropoietic anaemia type II (HEMPAS) and its molecular basis. | Congenital dyserythropoietic anaemia type II (CDA II) is a rare genetic anaemia in humans, inherited in an autosomally recessive mode. CDA II is also called HEMPAS as this disease is characterized by hereditary erythroblastic multinuclearity with positive acidified serum lysis test. Analyses of CDA II erythrocyte membranes showed that the band 3 glycoprotein is underglycosylated. An aberrant glycosylation pattern is seen in the polylactosamine carbohydrates which are normally attached to the band 3 and band 4.5 glycoproteins. The polylactosamines are, however, accumulated in the form of glycolipids. Therefore a genetic factor in CDA II appears to block the glycosylation of protein acceptors and shift these carbohydrates to the lipid acceptors. Structural analysis of CDA II band 3 carbohydrates identified truncated hybrid-type oligosaccharides and suggests that the Golgi glycosylation enzyme(s), alpha-mannosidase II or N-acetylglycosaminyltransferase II is defective in CDA II. By using a cDNA probe for alpha-mannosidase II, one CDA II case has been identified as being defective in the gene encoding alpha-mannosidase II. At present, it is not clear whether CDA II is a genetically heterogenous collection of glycosylation deficiencies, or genetically homogenous but apparently heterogenous in phenotype expression. Freeze-fracture electron microscopy and immunoelectron microscopy revealed that the band 3 glycoproteins are clustered in CDA II erythrocyte membranes. The abnormal distribution of band 3 might cause an unstable membrane organization. In CDA II erythroblasts, the membrane proteins might also be underglycosylated and abnormally distributed. When normal erythroblasts were cultured in vitro in the presence of swainsonine (alpha-mannosidase inhibitor) the erythroblasts became multinucleared. It is, therefore, quite possible that the enzymic defect of alpha-mannosidase II could cause various morphological anomalies including multinuclearity. Because the genes encoding glycosylation enzymes are housekeeping genes, the enzyme defect of CDA II is not restricted to erythroid cells and there is also an abnormal glycosylation of hepatocyte glycoproteins. On the other hand, there are many types of cells and tissues which appear not to be affected by the CDA II defect. A mechanism for the erythroid-specific manifestation of CDA II and its tissue specificity are also discussed. |
8043933 | The role of Rh antibodies in haemolytic disease of the newborn. | Recent insights into the structure-function relationship of IgG, the nature of Fc receptors and their interactions with antibodies, and the cellular mechanisms involved in the immune destruction of IgG-sensitized cells have all contributed to a fuller understanding of the role of Rh antibodies in HDN. As this understanding has increased, so different diagnostic and therapeutic approaches have been developed and evaluated in order either to predict or ameliorate disease severity. The role of Rh antibodies in HDN can be considered in three contexts: maternal anti-D, monoclonal anti-D and prophylactic anti-D. Anti-D formed after maternal alloimmunization may be transported across the placenta, resulting in destruction of sensitized red cells by mononuclear phagocytes in the fetus and infant. The use of monoclonal anti-D has given an insight into the cellular and molecular mechanisms involved in red cell destruction, and has facilitated the development and evaluation of assays which use maternal anti-D to predict the severity of HDN. Polyclonal anti-D, given prophylactically, can prevent maternal alloimmunization to D-positive fetal red cells. Future developments are likely in several areas. Prophylactic polyclonal anti-D may be replaced, wholly or partially, with monoclonal anti-D. The development and introduction of cellular assays as non-invasive tests for predicting disease severity is likely to continue as preliminary results are encouraging. Finally, new strategies for ameliorating disease severity may be assessed including the role of ivIgG and Fc gamma R-blocking antibodies. |
8043932 | Biochemical aspects of the blood group Rh (rhesus) antigens. | Despite their importance in clinical haematology, the details of the structures and possible functions of the proteins associated with Rh antigen expression have only recently begun to emerge. The antigens are carried by a multimeric complex between a M(r) 30,000 polypeptide which is not glycosylated (the Rh30 polypeptide), and a heavily glycosylated glycoprotein (the Rh50 glycoprotein). The N-terminal amino acid sequences of the two types of proteins were determined and used to isolated cDNA clones. The Rh30 and Rh50 proteins are both very hydrophobic membrane proteins, each containing up to 12 membrane spans. The two proteins are homologous in sequence and clearly belong to the same family. They are erythroid-specific and not related to any other known family of proteins. The Rh30 polypeptides are the genetic determinants of Rh blood group antigen activity. One polypeptide (Rh30A) is probably associated with CcEe antigen activity, while another (Rh30B) is responsible for the D antigen. The proteins have structures typical of transporters but their functions are still unclear. A number of other red cell membrane proteins (LW, CD47, glycophorin B and Fy) show alterations in red cells lacking Rh antigens (Rhnull). These proteins may have a role in the biosynthesis or function of the Rh30 and Rh50 proteins. |
8043931 | The membrane defect in hereditary stomatocytosis. | Hereditary stomatocytosis and allied conditions represent a series of diseases in which abnormal movements of univalent cations across the plasma membrane play an important part in cellular disease. The primary problem lies not in the active transporters but in the basal permeability of the membrane, which is always increased, and the extent of the increase correlates with the cellular dysfunction. A number of structural abnormalities have been described in these membranes, but the most consistent and convincing is the deficiency of a hitherto uncharacterized integral membrane protein of molecular weight 31 kDa in the severe, 'overhydrated' form of the disease. The true function of this protein remains enigmatic, but its deficiency in this condition indicates that it may have a role in the regulation of cation transport. |
8043929 | The major integral proteins of the human red cell. | The structures and functions of the major human red cell integral membrane proteins are summarized in this review. The proteins that are discussed are the anion transporter (band 3), the sialic acid-rich glycophorins and the glucose transporter. Band 3 (AE1) is a member of a family of anion transporters which carry out Cl-/HCO3- exchange. AE1 is largely restricted to red cells and functions in CO2 transport between the tissues and lungs. In addition to its transport function band 3 acts as an anchor site to the membrane of the red cell skeleton, and also binds a number of cytoplasmic red cell proteins. Variant forms of band 3 are known and some of these have an effect on red cell function and viability. The glycophorins comprise three major proteins, glycophorin A (GPA), glycophorin B (GPB) and glycophorin C (GPC). GPA and GPB (together with another putative gene product, GPE) are closely related products of highly homologous genes located in tandem on the human chromosome. The similarity between the genes gives rise to a number of genetic variants as a result of unequal crossover events. The gene products are erythroid specific. The function of the proteins is not clearly established, but GPA appears to have a role in facilitating the movement of band 3 to the cell surface during the biosynthesis of the latter. The GPC gene is not related to the GPA, GPB and GPE gene family. This gene gives rise to GPC and a form of GPC which is truncated at the N-terminus and is designated GPD. GPC functions in anchoring the red cell skeleton to the membrane, and absence of the protein is associated with red cell abnormalities. GPC transcripts are found in many other tissues, where they probably also have a role in cytoskeletal interactions. The red cell glucose transporter (GLUT1) is a member of the gene family of passive glucose transporters. GLUT1 is not erythroid specific but is also present in several other tissues. |
8043928 | A retrospective analysis of laparoscopic and open cholecystectomies. | A total of 686 consecutive cases were reviewed for comparison between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC). The procedures were performed by the teaching surgical service of a community hospital. Between March 1989 and December 1992, 381 patients had LC, 262 had OC, and 43 patients had attempted LC that was converted to open cholecystectomy (CONV). Postoperative hospital stay for LC was 2.9 +/- 3.7 days (range 12 h to 28 days) and was significantly less than those for OC (12.4 +/- 23.6 days) or CONV (8 +/- 8.3 days) (p < 0.0001). Patients who had LC revealed meaningfully decreased perioperative or postoperative antibiotic use, postoperative temperature elevations, and hospitalization when compared to OC or CONV (p < 0.0001). Bile duct injury was 0.26% with LC and 0.38% with OC. The percentage of postoperative bile leakage was 0.79% and 0.38% for LC and OC, respectively. LC cases were associated with lower complication rates when compared to OC or CONV (p < 0.005). No deaths were observed with LC (0%). However, the mortality rate for OC was 1.5%. The results of LC were more favorable than those of OC and CONV with respect to complications, morbidity, mortality, and length of hospital stay. Based on our experience, the patient outcome for LC was superior to OC. |
8043927 | Laparoscopic cholecystectomy in pregnancy. | Acute calculus cholecystitis during pregnancy can be a difficult management problem. Two pregnant patients with cholecystitis refractory to conservative management underwent laparoscopic cholecystectomy at a community hospital. One patient was treated under epidural anesthesia. Pregnancy should not be an absolute contraindication to laparoscopic cholecystectomy, and epidural anesthesia should be considered. |
8043926 | Laparoscopic unroofing of multiple benign liver cysts with intraperitoneal drainage: a case report. | The treatment of symptomatic congenital hepatic cysts is surgical. Aspiration does not provide definitive therapy and carries a high recurrence rate. Surgical exploration and drainage intraperitoneally, externally, and internally to a segment of bowel have been described. With the recent explosion in the applications of laparoscopic guided surgery, we report a simple method for the excision of congenital solid hepatic cyst with subsequent intraperitoneal drainage and follow-up. |
8043925 | Laparoscopic repair of a penetrating injury to the diaphragm: a case report. | A traumatic diaphragmatic hernia that appears late may have a fatal outcome. Traditionally, the most sensitive diagnostic modality for diaphragmatic injuries has been laparotomy. This results in unnecessary laparotomies. Laparoscopy is now an alternative method for the diagnosis and treatment of numerous intraabdominal disorders. We present a case of a penetrating diaphragmatic injury that was diagnosed and repaired via the laparoscope. |
8043924 | Cystic duct stabilization during laparoscopic exploration and stone removal. | A modification of the standard method for cystic duct stabilization is presented. A percutaneously placed suture is used to loop and stabilize the cystic duct. The suture is secured outside the abdominal wall at the skin level using a clamp. Percutaneous suture stabilization of the cystic duct provides an alternative method of common bile duct stabilization when laparoscopic choledochotomy is required. By using this method, we can easily stabilize the cystic duct without the need for additional trocars and simplify the use of the choledochoscope. |
8043923 | A new technique of fascial closure for laparoscopic incisions. | The objective was to develop a technique and instrumentation for closure of 10-mm and larger laparoscopic incisions with a single instrument under direct laparoscopic vision, ensuring complete fascial and peritoneal closure. The Carter-Thomason Needle-Point Suture Passer functions as both a needle and a grasper, allowing for performance of laparoscopic directed fascial and peritoneal closure. It uses a 2.7-mm diameter grasping tool with a single-action jaw. The device introduces the suture through the muscle, fascia, and peritoneal layers under direct laparoscopic vision, drops the suture, picks it up at the opposite side of the opening, and is withdrawn grasping the suture. The surgeon completes the mass closure of the layers by tying the suture below the skin. Pneumoperitoneum is maintained. The closed peritoneal layer is viewed through the laparoscope, and palpation of the closure ensures that the fascial layer is completely occluded. The Carter-Thomason Needle-Point Suture Passer has been used as a single instrument for closure of 10-mm and larger incision sites in over 200 advanced laparoscopic procedures since March 1993. No incisional hernias or complications of the incisional site have occurred. This instrument and the technique have been used for ligation to control hemorrhage from a lacerated inferior epigastric vessel, with successful ligation obtained in less than 5 min. It also was used to pass suture to allow ligation of the infundibulopelvic ligament. This device provides complete and secure closure of operative incisions of 10 mm or larger, thereby reducing the risk of herniation during the postoperative recovery period. |
8043922 | Reusable laparoscopic instrument systems: an analysis of quality and cost issues. | This report is the first in a multihospital study designed to examine quality and cost variables associated wih reusable laparoscopic cholecystectomy instrument systems and the economic impacts of instrument reuse practices in hospitals. |
8043921 | Laparoscopic treatment of hydatid cyst of the liver: initial experience with a small series of patients. | A laparoscopic technique to manage hydatid cyst of the liver is described. The technique is safe and simple and has the advantages of other abdominal laparoscopic operations. It also fulfills the prerequisite of open surgery of hydatid cyst of the liver, namely, the prevention of intraperitoneal spillage of cyst contents. Our technique enables treatment of the residual cyst cavity following aspiration of contents. In the past 15 months, 10 cysts (5-17 cm in diameter) in 6 patients were managed successfully using this approach, with no mortality or short-term recurrence. |
8043920 | Laparoscopic management of gallstone pancreatitis. | Thirty-seven patients with gallstone pancreatitis were encountered over a 28-month period from June 1990 to October 1992. The use of laparoscopic cholecystectomy with intraoperative cholangiography in the management of gallstone pancreatitis was retrospectively studied. Thirty-two women and 5 men ranged in age from 16 to 74 years. Admitting amylase levels ranged from 241 to 5547 IU/L. No patient had a clinical history consistent with other causes of pancreatitis. Initial treatment consisted of bowel rest until amylase levels had normalized and abdominal tenderness had resolved. Twenty-nine of 37 patients were initially treated laparoscopically, but 7 required conversion to open cholecystectomy. Choledocholithiasis was identified intraoperatively in 4 patients. These stones were cleared either laparoscopically (2), by open common bile duct exploration (1), or by postoperative endoscopic retrograde cholangiopancreatography (1). Patients treated laparoscopically had a median postoperative discharge time of 1.0 day vs 3.5 days for those treated by open technique. Not all patients with gallstone pancreatitis can be treated successfully using laparoscopic techniques. As the experience and confidence of surgeons increases, laparoscopic management of gallstone pancreatitis is appropriate, with open conversion as necessary. |
8043919 | Caudal epidural block for analgesia following herniorrhaphy with laparoscopy in children. | This study prospectively evaluated the efficacy of caudal epidural block in providing analgesia following inguinal herniorrhaphy and laparoscopy. Laparoscopy was used only to inspect the contralateral side to determine if a second hernia was present. No surgical manipulation was performed through the telescope. Following mask induction with halothane in nitrous oxide and oxygen, a caudal epidural block was performed with 1.2 mL/kg of 0.25% bupivacaine. Pain scores were obtained at four points during the in-hospital postoperative course, and the need for supplemental analgesic agents was assessed. A total of 45 patients were studied. Caudal epidural block could not be performed in 1 patient, and this patient was excluded from further consideration. There were 34 boys and 10 girls, ranging in age from 2 to 84 months (mean +/- SD 37.4 +/- 18.2 months) and weighing from 3.4 to 34 kg (mean +/- SD 14.2 +/- 5.8 kg). Thirty-six of 44 patients (82%) did not require supplemental analgesic agents during their in-hospital postoperative course and had pain scores of 2 or less at all four evaluation points. Six of 8 patients required a single dose of intravenous fentanyl (0.5 microgram/kg) to maintain scores of 2 or less. No significant complications related to caudal epidural block were noted in any patient. Caudal epidural block provides effective analgesia following inguinal herniorrhaphy and laparoscopy in children. |
8043918 | Extraperitoneal endoscopic gasless pelvic lymph node dissection. | The insufflated extraperitoneal approach to endoscopic pelvic lymph node dissection has been described as an alternative method of staging carcinoma of the prostate. There are several potential pitfalls in performing this approach, including the use of endoscopic instrumentation, trocars, insufflation equipment, and general anesthesia. In order to overcome potential problems associated with this surgical approach, a totally gasless extraperitoneal approach has been developed. This technique uses standard surgical instruments, does not use carbon dioxide to maintain the operative space, and uses general anesthesia. This procedure is more cost effective, since it uses no special instrumentation except the laprolift and laprofan to maintain the extraperitoneal cavity during lymph node dissection. |
8043917 | Evaluation of staples and prostheses for use in laparoscopic inguinal hernia repair. | With the increasing popularity of laparoscopic prosthetic inguinal hernia repair, it was decided to compare the various staples and prostheses currently in use. A twofold increase in breaking or opening strength was required to disrupt the Endoscopic Multifeed Staple (31.2 Newtons vs 15.6 Newtons) compared with the Multifire Endo Hernia Staple. A linear relationship existed between the number of staples used and the maximum load tolerated. No significant difference was found between the breaking strength of the prostheses evaluated. Further research into the biomechanics of laparoscopic inguinal hernia repair is necessary to determine how important staple and prosthesis strength is for the success of the repair. |
8043916 | Laparoscopic cholecystectomy in a community hospital: experience with 600 laparoscopic cholecystectomies. | We reviewed 600 patients who underwent laparoscopic cholecystectomy (LC) in a teaching community hospital from May 1990 to August 1992. The safety, efficacy, morbidity, and mortality of LC, as performed by one surgeon or under his direct supervision, were studied. Five hundred forty-eight patients (91.3%) were treated electively; 52 (8.7%) were admitted for acute cholecystitis (41) or gallstone pancreatitis (11). Mean operating time was 54 min, with a range of 20 to 145 min. Twenty-four (4%) patients required conversion to traditional (open) cholecystectomy. Operative cholangiograms were completed in 106 patients. These revealed choledocholithiasis in 7. Five hundred thirty-seven patients (89.5%) were discharged within 24 h and 564 (94%) within 48 h. The overall morbidity of 9.2% compared favorably with both open and laparoscopic series previously reported. Three patients (0.5%) had small lacerations of the anterior wall of the common duct. Two were recognized and repaired immediately. The third patient came for treatment on the fifth postoperative day and was stented by a T-tube. There was 1 death in this group--a myocardial infarction on postoperative day 4. |
8043915 | Tryptic peptide mapping of sequence 1-298 of human serum albumin by high-performance liquid chromatography and fast-atom bombardment mass spectrometry. | The determination of the tryptic peptide mapping of sequence 1-298 of human serum albumin (HSA) by chemical and enzymatic cleavage and combined use of high-performance liquid chromatography (HPLC) and fast-atom bombardment mass spectrometry (FAB-MS) is described. A total coverage of about 75% of the entire sequence was obtained. Unidentified fragments included some peptides which were not present in the chromatograms because of their extreme hydrophobic or hydrophilic character, as indicated by the calculated retention times. Due to the high reproducibility of the experiments and to the satisfactory yield of the tryptic fragments identified, the combined use of HPLC and FAB-MS appears to possess great potential for structural investigation of HSA. |
8043914 | Different mass spectrometric approaches in the identification of endogenous methylated purine bases in urine extracts. | A preliminary identification of endogenous and exogenous methylated purine bases in urinary extracts of healthy and tumor-bearing subjects has been performed using high performance liquid chromatography, and tandem mass spectrometry (MS/MS). MS/MS gave particularly fast and sensitive analyses, allowing the simultaneous and rapid determination of 26 different urinary methylated purines. Both sets of data confirm that tumor-bearing patients show changed levels of methylated purine bases. |