Diagnostic criteria for scrub typhus: probability values for immunofluorescent antibody and Proteus OXK agglutinin titers

The sensitivities and specificities of the indirect microimmunofluorescent antibody (IFA) and Weil-Felix (OXK) tests for scrub typhus were established for a range of titers using groups of diseased and control (other febrile illnesses) patients diagnosed by other methods. At a cut-off point of greater than or equal to 1:400, the IFA test was 0.96 specific, and at greater than or equal to 1:320, the OXK was 0.97 specific. Using either these highly specific levels of antibody or other rigorous diagnostic criteria (isolation or 4-fold rising titers), the prevalence of scrub typhus infection was determined to be 0.22 in an unselected population of febrile patients in a rural Malaysian hospital. Probability values (Pr) for the correct diagnosis of scrub typhus were then calculated from the specificity, sensitivity and prevalence determination for a range of titers. The Pr for an OXK titer of greater than or equal to 1:320 was 0.79, and the Pr for an IFA titer of greater than or equal to 1:400 was 0.78. When both these titers were present in a single specimen, the Pr increased to 0.96.

Tc-99m MDP and indium-111 chloride scintigraphy in skeletal tuberculosis

A case of diffuse osseous tuberculosis with changes on skeletal Tc-99m methylene diphosphonate (MDP) and indium-111 chloride scintigraphy is presented. Only two other cases of bone scan findings in osseous tuberculosis (TB) were reported in the literature and both show patterns similar to diffuse metastatic disease. In addition, the demonstration of corresponding areas of decreased tracer activity on indium-111 bone marrow scintigraphy is a finding that has not been previously reported for skeletal tuberculosis.

Vestibular-proprioceptive functions in 4 year olds: normative and regression analyses

Normative data were obtained for 156 pre-school children's performances on measures of muscle tone, muscle co-contraction, standing balance, prone extension posture, flexion supine posture, asymmetrical tonic neck reflex, and postrotary nystagmus. Regression analysis indicated that these combined variables accounted for only 13.5 percent of the variance of postrotary nystagmus of 145 four year olds. However, if the data are examined only for children exhibiting nystagmus that is lower than 1 standard deviation below the mean, then these variables account for 50 percent of the variance of nystagmus. Prone extension posture, standing balance-eyes closed, and muscle tone account for 37 percent of the variance within this low-nystagmus population. These results are considered in light of the authors' previous studies demonstrating that, in learning-disabled children, vestibular-proprioceptive measures can be used clinically to predict which children will respond to sensory integration therapy with changes in postrotary nystagmus. These changes, according to sensory integration theory, reflect positive responses to therapy.

A search for trace expression of placental-like alkaline phosphatase in non-malignant human tissues: demonstration of its occurrence in lung, cervix, testis and thymus

A search for placental or placental-like human alkaline phosphatase (ALP) was made in human tissues. The tissue extracts were assayed for ALP before and after heating at 65 degrees C for 1 h. Trace amounts of heat-stable ALP activity (greater than 0.01 IU/g) were found in lung, testis, cervix and thymus. The heat-stable ALP in these four tissues gave in Ouchterlony double diffusion plates lines of apparent identity with placental ALP when a rabbit anti-human placental antiserum was used. Inhibition studies with L-phenyl-alanine (Phe), L-homoarginine (Har), L-phenylalanylglycylglycine (Pgg), L-leucine (Leu) and levamisole (Leva), were carried out on the heat-stable ALP and on the total ALP. The heat-stable ALPs from cervix and lung gave [I]50 values with each inhibitor comparable to those of placental ALP. The heat-stable ALPs froM testis and thymus gave [I]50 values for Leu and Pgg which were significantly different from the placental isoenzyme. Electrophoresis of heat-stable lung ALP from different individuals showed polymorphic differences similar to those seen with placental ALPs. Such differences were not seen with heat-stable testis ALP. We conclude that human non-malignant testis, cervix, lung and thymus tissues contain small amounts of placental or placental-like ALPs. The heat-stable ALPs in cervix and lung appear to have the same characteristics as placental ALP and are probably encoded by the same gene locus. The heat stable ALPs in testis and thymus, though immunologically very similar to placental ALP differ from it in inhibition profile and electrophoretically. The significance of the results in relation to the "ectopic' expression of placental and placental-like ALPs in malignancy is discussed.

Respiratory therapy as a component of an integrated hospital information system: the Parkland On-Line Information System (POIS)

Information handling is an important part of the activities of health care professionals, and the Parkland On-line Information System (POIS)--a computerized hospital information system--was established to more efficiently handle the processing and storage of information in our institution. Computerization of a respiratory therapy department is more effective if done in the context of a comprehensive, integrated hospital information system. Information and requests for services flow into the respiratory therapy departmental computer from other hospital terminals, and information, such as patient charges and statistical data, flow out of the departmental computer to those requesting such information. POIS is an implementation of the IBM Patient Care System. We have found that a computerized hospital information system can facilitate patient care by easing the burden of information processing.

Enhanced tumor growth in vivo by a factor in human platelets and rat liver

Liver cell supernatant and platelet extract can promote the in vivo growth of herpes simplex virus type 2-transformed hamster embryo fibroblast cells. Delineation of necessary growth factors for tumor cells in vivo may open up new strategies to inhibit malignant cell growth.

Evolution of alkaline phosphatases in primates

Alkaline phosphatase [orthophosphoric-monoester phosphohydrolase (alkaline optimum), EC 3.1.3.1] in placenta, intestine, liver, kidney, bone, and lung from a variety of primate species has been characterized by quantitative inhibition, thermostability, and immunological studies. Characteristic human placental-type alkaline phosphatase occurs in placentas of great apes (chimpanzee and orangutan) but not in placentas of other primates, including gibbon. It is also present in trace amounts in human lung but not in lung or other tissues of various Old and New World monkeys. However, a distinctive alkaline phosphatase resembling it occurs in substantial amounts in lungs from Old World monkeys but not New World monkeys. It appears that duplication of alkaline phosphatase genes and mutations of genetic elements controlling their tissue expression have occurred relatively recently in mammalian evolution.

High-temperature Disruption of Guard Cells of Vicia faba: EFFECT ON STOMATAL APERTURE

Increased variability in stomatal aperture at high temperatures can be attributed, in part, to the differential sensitivity of guard cells to thermal damage. Individual stomata become increasingly open at higher temperatures until guard cells are lethally damaged; at that temperature, apertures decrease. The extent of irreversible damage causing closure was estimated by K(+) uptake, neutral red accumulation, and visual scoring of chloroplasts.This study found that visual scoring of chloroplast disruption provided the best estimate of guard cell viability at high temperature. Removal of the damaged guard cells from the population sample resulted in a constant coefficient of variability for apertures over the temperature range 25 to 50 C.

The imbalance of chain synthesis in hemoglobin F

The synthesis of Hb F has been found to be unbalanced in a number of conditions, including homozygous HPFH, sickle-cell anemia, and normal term cord bloods. In this study, the counts from the pre-gamma and pre-alpha zones of the chain separation chromatogram are considered to be modified gamma and alpha chains, respectively, and are included in calculating the gamm/alpha ratios for cord blood and sickle-cell blood. The gamma chain is labeled about 52% as efficiently as the alpha chain in reticulocytes. It is possible that nu chain synthesis is balanced in the bone marrow, but subsequently becomes unbalanced in the reticulocyte.

Selective training of the vastus medialis muscle using EMG biofeedback

The purpose of this study was to investigate if, in three weeks, the vastus medialis muscle could be trained to contract independently of the vastus lateralis muscle. Ten subjects attended electromyographic biofeedback training sessions five days a week for three weeks for one half hour each day. During the first two weeks the subjects concentrated on decreasing the activity level of the vastus lateralis muscle, and during the final week they tried to increase the vastus medialis muscle activity level. Significant differences were found in the change in muscle activity level of the vastus lateralis muscle over the first two weeks, in the change of muscle activity level of the vastus medialis muscle over the third week, and in the difference between vastus medialis and vastus lateralis muscle activity levels from the first to the third weeks.

Qualitative and quantitative methods of studying the effect of lipids on bacteria grown on the surface of solid culture media

New qualitative and quantitative methods are described for the investigation of the antibacterial activity of lipids on solid media by the application of lipid-impregnated filter paper over a lawn of the organisms. The methods have been used to investigate the antibacterial activity of unsaturated fatty acids that are important in skin defence. Oleic and linoleic acids inhibited Streptococcus pyogenes markedly, Staphylococcus aureus and Staph epidermidis to a lesser extent and had no effect on Escherichia coli and Pseudomonas aeruginosa. The inhibition of growth of a strain of Str. pyogenes from a sore throat was greater than that of a strain from an outbreak of impetigo. Linoleic acid was a more potent inhibitor of bacterial growth than oleic acid, and with both acids inhibition was more pronounced under aerobic than under anaerobic conditions of incubation. The methods described could be applied in other fields such as pharmacology, horticulture and industry.

Dark Opening of Stomates of Vicia faba in CO(2)-free Air: EFFECT OF TEMPERATURE ON STOMATAL APERTURE AND POTASSIUM ACCUMULATION

Leaf epidermal strips of Vicia faba were floated on 10 millimolar KCl at temperatures of 10 to 45 C for several time periods in the dark. For the duration of the experiment, a jet of water-saturated, CO(2)-free air was passed over the strips. The width of the stomatal aperture was measured microscopically and the potassium content was estimated and expressed as the percentage of area of the guard cell pair stained with cobaltinitrite. Stomatal opening in the dark occurred at temperatures above 35 C. The high temperature aperture reduction previously observed at 45 C in the light was not observed in the dark. Potassium accumulation occurred at all temperatures except 10 C, with a maximum at 45 C, which appeared functionally different from that seen previously in the light.

Platelet adhesion and aggregation in diabetes mellitus

Platelets from diabetic patients show both increased platelet adhesiveness and sensitivity to aggregating agents. Plasma levels of the platelet-active von Willebrand Factor and the closely related factor-VIII antigen are significantly elevated, while factor VIII procoagulant activity is not. This may reflect either intravascular coagulation or disproportionate production or degradation. Plasma factors that enhance ADP-induced platelet aggregation are found in 50% of unselected male diabetics. Activity is clearly demonstrated only when plasma is added immediately prior to adding subthreshold doses of ADP to platelet-rich plasma obtained from control subjects. Systematic investigations of the molecular nature of such factors and their interactions with platelets are in progress. In platelets obtained from diabetic subjects, we have previously found increased sensitivity to the aggregating effects of arachidonic acid, and increased synthesis of immunoreactive prostaglandin E-like material. More recent studies have shown that platelets obtained from diabetic subjects are less sensitive to the antiaggregatory effects of imidazole, a thromboxane synthetase inhibitor. These observations suggest that increased synthesis of the labile aggregating substance thromboxane A2 also occurs in platelets obtained from diabetics. Collectively, these platelet and plasma abnormalities may contribute to accelerated vascular disease of diabetes. Prospective studies using antiplatelet agents are presently underway or in the planning stages in diabetics to explore their potential beneficial effects.

Guidelines for health education in maternal and child health

Guidelines are presented for specifying objectives, identifying resources, selecting methods and evaluating the health education component for maternal and child health programmes. Examples of the application of the principles are integrated with the Guidelines. Diagnostic, planning, organizational, administrative and evaluative procedures are presented around a model of health education which emphasizes: a) the careful delineation of the health problem; b) the specification of behaviours influencing the health problem; c) setting priorities among target behaviours on the basis of their relative epidemiological importance and their changeability; and d) the identification of factors that predispose, enable and reinforce the behaviour.

A new anorexigen assay: stress-induced hyperphagia in rats

Humans often respond to stress by overeating. A rat model of hyperphagia induced by a stressful tail-pinch has been described. Consumption of sweetened condensed milk by vaive rats was measured durin the stress. This milk drinking was prevented by pretreatment with d-amphetamine, chlorphentermine, diethylpropion, fenfluramine, methamphetamine, morphine, chlorpromazine and haloperidol. The benzodiazepines chlordiazepoxide and diazepam increased the hyperphagia. The relevance of dopaminergic agonistic and antagonist activities to anorexigenic activity are questioned.

Cat sleep: a unique first night effect

Longitudinal sleep studies in chronically implanted cats revealed a unique first night effect. Unlike other species, during the first 24 hr of sleep recording, the electroencephalogram and reticular formation multiple unit activity revealed more rapid eye movement sleep occurred than during subsequent 24 hr recording sessions. In addition, higher rapid eye movement to slow wave sleep ratios were observed for the first 24 hr as compared to the following days. An increase in wakefulness and decrease in slow wave sleep occurred on the third recording day as compared to the initial 24 hr period. These data have important implications for studies of variables on the sleep pattern of animals.

Decompressive craniectomy for the encephalopathy of Reye's syndrome

Report of the successful use of a decompressive craniectomy for the encephalopathy of Reye's syndrome with increased intracranial pressure. The patient had failed to respond to all medical management.