Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis

23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied. Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis. 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment. The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID. Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis. This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract. Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigation.

Characterization of conformers of D 1 of photosystem II using site-directed antibodies

Antibodies have been raised to synthetic peptides, corresponding to a region in the loop spanning helices 4 and 5 of D 1 protein (Ala 250-Phe 265) and to a region anticipated to be near the C terminus of mature D 1 (His 332-Ala 345). Polyclonal antibodies to the sequence His 332-Ala 345 reacted with a 32 kDa polypeptide in thylakoid preparations identified as D 1 from its resistance (pea) or susceptibility (wheat) to lysine-C degradation. A monoclonal antibody to His 332-Ala 345 reacted preferentially with a faster migrating polypeptide in SDS electrophoresis, a putative conformer of D 1. Polyclonal antibodies to the sequence Ala 250-Phe 265 also reacted with the faster running polypeptide but not with the population of molecules running at 32 kDa. The putative conformer of D 1 from wheat appears to be more resistant than the main D 1 population to lysine-C degradation. Peptide analyses by Takahashi et al. [(1988) FEBS Lett, 240, 6-8] suggest Asn 335-Ala 344 lies at the processed C terminus. The present report provides immunological confirmation that this sequence is retained in mature D 1.

Cobalt probing of structural alternatives for insulin in solution

Inorganic anions and phenolic compounds make the subunits of insulin hexamers undergo the T----R transition whereby the extended N-terminal B chain becomes helical and the octahedral metal coordination tetrahedral. The role of the metal ions is permissive. With cresol the transition is also undergone by metal-free hexamers. For coordinative reasons only zinc insulin can be transformed by moderate concentrations of inorganic anions. At higher concentrations and particularly with cresol transformation is also possible if Zn2+ is replaced by other metal ions. Owing to its d--d transitions in the visible cobalt lends itself as a spectroscopic probe for studying the interdependence of transformation and coordination. The transformation-related change in coordination is reflected in both the isotropic absorption and the CD spectrum. Cresol achieves T6----R6 transformation whereas that induced by SCN- ions is T6----T'3R3 with only the axial metal-binding site being realized in the R3 trimer. The spectral effects of the transformation of the two trimers are not additive; an extra contribution seems to be indicative of trimer/trimer interaction. Oxidation of 2 Co2+ insulin to a certain extent affects the structure of insulin; a characteristic positive band appears at 251 nm. Because of its extremely stable and exclusively octahedral complexes the Co3+ ion most strongly withstands transformation. The oxidation of tetrahedrally liganded Co2+ ions in R3 trimers proceeds with reduced velocity. Independent transformation of the Zn2+ trimers is possible in Zn2+/Co3+ metal hybrids of insulin.

Chlamydia trachomatis in reactive arthritis

Evidence of deposition of chlamydial antigen in the joint was sought in 10 patients (9 of them male) with classic sexually acquired reactive arthritis, 15 women with unclassified seronegative oligoarthritis involving the knee and 15 individuals with established rheumatic disorders not associated with genital-tract or other infections. Using a fluorosceinated monoclonal antibody to the major outer membrane protein of Chlamydia trachomatis (MicroTrak, Syva) in a direct immunofluorescence test, particulate antigen with physical characteristics of chlamydial elementary bodies was seen in synovial fluid cell smears or synovial biopsies, or both, from 6, 5, and 0 patients, respectively. No typical chlamydial intracellular inclusions were seen. Corroborative evidence of recent chlamydial infection was provided by the finding of high titres of serum chlamydial antibody in all antigen-positive patients with sexually acquired reactive arthritis, including 3 from whom a genital-tract isolate was obtained, and 3 of the 5 women with unclassified arthritis. It is postulated that Chlamydia trachomatis organisms reach the joint during acute genital-tract infection, and the processing and presentation by class I major histocompatibility determinants of chlamydial antigens is a critical step in the initiation of reactive arthritis in some patients.

Action spectrum for the effect of day-extensions on flowering and apex elongation in green, light-grown wheat (Triticum aestivum L.)

Fluence-rate response curves for wavelengths from 640 nm to 730 nm were constructed for the day-extension promotion of flowering in green, light-grown, wheat (Triticum aestivum L., cv. Alexandria), a long-day plant. The resultant action spectrum had action maxima at 660 nm and 716 nm and resembles spectra for the high-irradiance reaction (HIR) seen in etiolated plants. Because, the HIR is thought to be controlled by type I pytochrome (that which is most abundant in etiolated tissue) our results indicate the involvement of type I phytochrome in the photomorphogenesis of a light-grown, green plant.

Noninvasive measurement of respirator effect at rest and during exercise

Ventilation and respiratory timing during rest and exercise were measured in normal volunteers by pneumotachograph and by respiratory inductive plethysmography (RIP) to determine if RIP is accurate and to determine if the usual methods of ventilation measurement during respirator research lead to artifacts. Data were collected with a mouthpiece, a sham mouthpiece, and no mouthpiece. A dead space and inspiratory resistance load similar to respirators were employed also. The study showed that no significant artifact is produced, particularly during exercise, by measurements using a mouthpiece. RIP is sufficiently accurate and precise for use in unobtrusively measuring ventilation during respirator studies when traditional methods cannot be used.

Increased plasma triglyceride secretion in EFA-deficient rats fed diets with or without saturated fat

Metabolic responses to essential fatty acid-deficiency in rats include an increased rate of triglyceride secretion into the plasma, a large reduction in the HDL1 plasma lipoprotein concentration, and increased concentrations of liver triacylglycerols and cholesteryl esters. Because of differences in the types of EFA-deficient diets used, it is not clear whether these responses were solely due to the absence of EFA from the diet or whether saturated fat, or differences in acyl group chain length in this fat, might be responsible. Therefore, we fed rats diets differing only in amounts and kinds of fat, and measured triacylglycerol secretion rates and liver concentrations of triacylglycerols and cholesteryl esters, for comparison with our earlier measurements of plasma high density lipoprotein subpopulations in rats fed exactly the same diets. The purified diets contained either no fat, 5% by weight hydrogenated coconut oil, 5% hydrogenated cottonseed oil, or each of these three diets supplemented with 1% safflower oil, or 5% corn oil. We also fed some rats a nonpurified stock diet for comparison with literature reports. The present results indicate that the metabolic responses to essential fatty acid deficiency described above are definitely due to essential fatty acid-deficiency and not to the presence or chain length of acyl groups in saturated fat in the diet.

A placebo-controlled, double-blind crossover study of naltrexone hydrochloride in outpatients with normal weight bulimia

The endogenous opioid system plays an important role in the control of feeding behavior. Previous research has shown that antagonism of endogenous opioids will suppress feeding in certain models in both human and infrahuman species. In the current study, 16 normal-weight bulimic women were treated with low-dose naltrexone, the long-acting, orally active narcotic antagonist, and placebo in a crossover design. The use of the active drug was not associated with a clinically significant reduction in binge eating or vomiting episodes. Suggestions for further research in this area are offered.

[Essential hypertension caused by a virilizing adrenal tumor]

Authors report here an interesting case of a woman who has been treated for essential hypertension for 12 years. Beside the hypertension, an extreme virilization appeared. A large adenoma, originated from the left adrenal gland have been explored behind the clinical picture. After surgical removal of the adenoma, adrenocortical hormones decreased to the normal levels. Systemic blood pressure decreased considerably the virilisation showed gradual involution. The correct treatment of the patient was a decade late, resulting in the development of encephalopathic syndromes.

Strain comparison of systemic N-nitrosohexamethyleneimine carcinogenesis in BALB/c, SENCAR and CD-1 mice

SENCAR mice have been selectively bred for hypersusceptibility to 2-stage chemical skin carcinogenesis. In this study the relative susceptibilities of SENCAR, BALB/c and CD-1 mice to systemic carcinogenesis by N-nitrosohexamethyleneimine (NHEX) were examined. NHEX was administered twice weekly (1 mg/mouse) in corn oil by gavage for 30 weeks. NHEX caused primarily liver and lung tumors in all 3 strains of mice. Hemangiosarcomas (but not other liver tumors) were more common in CD-1 mice than BALB/c or SENCAR mice. Lung tumors (adenomas and adenocarcinomas) and forestomach tumors (squamous carcinomas) were more common in SENCAR mice than BALB/c or CD-1 mice. Survival was better in SENCAR mice dosed with NHEX than in the other 2 strains. These results indicate that SENCAR mice are not unusually sensitive to liver carcinogenesis by NHEX, but are relatively sensitive to tumorigenesis in 2 epithelial tissues, lung and forestomach.

Plasma growth hormone-releasing hormone levels in type 1 (insulin-dependent) diabetic children following a mixed meal

Following a mixed meal, plasma hormone responses were measured in four type 1 diabetic children and in eight short normal children. Between 60 and 150 min after ingestion of the mixed meal there was a significant increase in circulating growth hormone-releasing hormone values both in diabetic and in normal children. Mean plasma GHRH peak values were not different between diabetic patients (27.0 +/- 3.9 ng/l) and controls (24.6 +/- 4.9 ng/l). No time relationship to spontaneous growth hormone peaks was observed. Whereas normal children showed a characteristic biphasic plasma somatostatin response, somatostatin plasma levels in diabetic children did not change. In normal children plasma insulin values increased between 30 and 150 min, but remained unchanged in type 1 diabetic patients. Blood glucose response was more pronounced in diabetic children than in short normal children. These results indicate that circulating growth hormone-releasing hormone does not play a dominant role in the regulation of insulin and somatostatin.

Plasma levels of growth hormone-releasing hormone and somatostatin in response to a mixed meal and during sleep in children

Following a mixed meal, plasma levels of GHRH, GH, SRIH and insulin were measured in 7 prepubertal children with constitutional delay of growth and adolescence (CDGA) and in 3 children with proven GH-deficiency which responded to GHRH-injection. In children with CDGA, plasma levels of GHRH increased between 60 and 120 min (10.1 +/- 1.2 ng/l vs 25.5 +/- 4.4 ng/l; P less than 0.01). Although no GH increase occurred in patients with GH-deficiency, their plasma GHRH increases were comparable to those in CDGA children. No time relationship was present between circulating GHRH and GH, SRIH, or insulin, nor was there any correlation between their integrated hormone response areas. Sleep-induced plasma GHRH, GH and SRIH values were determined in 10 prepubertal children with CDGA. Spontaneous variations of plasma GHRH and GH values occurred with no temporal or quantitative relationship. SRIH values did not change during nocturnal sleep. In one child with GH-deficiency, comparable GHRH plasma fluctuations occurred, although GH values were all below 1 microgram/l. Our results support the concept that circulating GHRH does not only represent hypothalamic GHRH, but derives mainly from extrahypothalamic sources, possibly from the gastrointestinal tract.

Chromosome protection by WR-2721 and MPG-single and combination treatments

The radioprotective action of thiol compounds 2-mercaptopropionylglycine (MPG) and S-2(aminopropylamino) ethyl phosphorothioic acid (WR-2721) was evaluated either alone or in combination on the bone marrow chromosomes of Swiss albino mice after 4.5 Gy of 60Co radiation. Single drug administration of WR-2721 at 300 mg/kg body weight resulted in a 50% reduction in the yield of aberrant cells at 24 hours post irradiation, while the other single drug doses were less effective. The combination of the two drugs increased the effect in the sense that 150 mg/kg WR-2721 with 20 mg/kg MPG gave equal protection as 300 mg/kg WR-2721 given alone. Moreover, on day 14, when WR-2721 produced an increase in the precent aberrant cells the above combination brought down the value to normal. It appears that MPG neutralizes to some extent the toxic effect of WR-2721, without impairing the protective efficiency.

Chlamydia trachomatis and reactive arthritis: the missing link

Reactive inflammatory arthritis is a common sequel to sexually acquired non-gonococcal genital-tract infection. Approximately 50% of cases are associated with Chlamydia trachomatis infection in the genital tract, although conventional cultures of joint material are sterile. Synovium, synovial-fluid cells, or both, from eight patients with sexually acquired reactive arthritis (SARA) and eight with knee effusions associated with other rheumatic diseases were examined by means of a fluorescein-labelled monoclonal antibody to C trachomatis ('Micro Trak'; Syva). Typical chlamydial elementary bodies were seen in joint material from five patients with SARA but in none of the controls. An inclusion-like cluster of elementary bodies was seen in one synovial biopsy sample. All five patients had high titres of serum chlamydial antibody. It is likely that the synovitis of SARA results directly from the presence of chlamydial elementary bodies in the joint.

Exogenous reinfection with tuberculosis in a shelter for the homeless

We investigated an outbreak of tuberculosis in a large shelter for the homeless to assess the role of exogenous reinfection as opposed to reactivation of endogenous infection as the cause of secondary tuberculosis in this population. Exogenous reinfection is considered relatively unimportant in the United States and other developed countries. Of 49 shelter-related cases, 22 had cultures resistant to both isoniazid and streptomycin and of the same phage type, indicating recent transmission originating with a single index patient. The probable index patient had a 10-year history of isoniazid and streptomycin resistance--an uncommon pattern at the shelter during the three years preceding the outbreak. In 4 of the 22 cases, the patient had previously had documented tuberculosis infection or disease. These reinfected patients had extensive lung cavitation and numerous acid-fast bacilli on sputum smears--features associated with contagiousness. In contrast, patients with tuberculosis for the first time (primary tuberculosis) are usually less contagious. We conclude that exogenous reinfection may have been an important factor leading to highly contagious secondary cases and an acceleration of the usual pattern of tuberculosis transmission in this highly susceptible population.

Artifacts in MR imaging after surgical intervention

Artifacts are encountered repeatedly in magnetic resonance (MR) imaging after neurological orthopedic surgery, although there is no evidence of metallic foreign bodies on radiography and CT. Experiments demonstrated that surgical filling materials, such as bone cement and bone transplants are not the cause of the artifacts. On the other hand, we have been able to show that short-term contact between a diamond drill and untempered operating instruments can cause abrasions and set free minute metallic fragments. Those particles are missed by X-ray procedures including CT but cause MR artifacts by local disturbance of the homogeneity of the magnetic field. Therefore, MR represents a highly sensitive method to trace extremely small amounts of magnetic substances. Postsurgical MR, however, may be of limited value because of the disturbing artifacts.

Nursing care of the dying: its relationship to selected nurse characteristics

This study examined the relationship between the quality of nursing care given to terminally-ill patients and their families, and selected characteristics of 210 nurses caring for terminally-ill patients. Mailed questionnaires received 90% response from nurses in a two-stage, stratified, proportionate, random sampling plan. Independent variables studied were: death anxiety, educational experience, personal experience and professional experience. Dependent variables studied were three measures of the quality of nursing care: communication, continuity of care and family care. Kendall's tau and parametric partial correlation coefficients were used for data analysis. The study results show that 13 of the 18 statistical tests were significant at 0.05.

Ultrasonographic diagnosis of asymptomatic cholelithiasis in pregnancy

Using a static B scanner, 203 pregnant patients underwent cholecystosonography at the time of a routine 24-week ultrasound study. The incidence of asymptomatic cholelithiasis, 2.5%, was less than that reported by others. This low incidence and the increased time needed for cholecystosonography suggest that studies should be done on symptomatic patients only.

Recombination hot spot in the human beta-globin gene cluster: meiotic recombination of human DNA fragments in Saccharomyces cerevisiae

We describe a novel system for the analysis of sequence-specific meiotic recombination in Saccharomyces cerevisiae. A comparison of three adjacent restriction fragments from the human beta-globin locus revealed that one of them, previously hypothesized to contain a relative hot spot for genetic recombination, engages in reciprocal exchange during yeast meiosis significantly more frequently than either of the other two fragments. Removal of the longest of four potential Z-DNA-forming regions from this fragment does not affect the high frequency of genetic recombination.