Serum immunoglobulins and immunoglobulin G subclasses in cystic fibrosis related to the clinical state of the patient

Levels of serum immunoglobulins and immunoglobulin G subclasses were measured in 32 cystic fibrosis (CF) patients, 30 asthmatics and 27 controls. When compared with the asthmatic patients and controls, the CF patients had raised levels of all IgG subclasses as well as total IgG, IgM and IgA, but there was not a statistically significant increase in IgE. The levels of immunoglobulins in the CF patients were examined in relation to the clinical features of the disease. Raised levels of IgG4 were related to levels of IgE, but these raised levels of IgG4 appeared to be part of a general increase in total IgG and not an isolated feature. There was a significant correlation between the total IgG level and its subclasses, IgG1, IgG2, IgG3, IgG4 and IgA. IgG1 was significantly correlated with IgG2 and IgG4; IgG2 with IgG4; and IgG4 with IgE. Total IgG was the immunoglobulin most closely correlated with poor lung function. Serum IgA was higher in patients with positive immediate skin prick reactions to pollens (p less than 0.005) and death within two years of the study was related to high levels of total IgG (p less than 0.01), IgG3 (p less than 0.001), IgA (p less than 0.001), and IgE (p less than 0.005).

Associations between phenomenal and objective aspects of concentration problems in depressed patients

The paper explores a distinction between different kinds of lapse of concentration in depressed patients. The strategy is to begin with the phenomenological distinction between the mind (a) 'wandering' on to something else or (b) going 'blank'. Blanking, but not mind-wandering, is associated with longer planning times on the 'Tower of London' task. In contrast, mind-wandering but not blanking, is associated with poor memory for prose, at least under ordinary processing conditions. Different phenomenal forms of concentration problem thus have different task performance correlates. A tentative formulation is offered in terms of Shallice's model of the regulation of attention. Mind-wandering is seen as a problem of 'contention scheduling', and blanking as the result of generalized inhibition by the Supervisory Attentional System. It is evident that not all performance deficits in depression can be attributed to the cognitive capacity taken up by competing thoughts.

Demographic and practice characteristics of chiropractors

The purpose of this study was to determine the demographic and practice characteristics of chiropractors. A four-part survey questionnaire was developed and mailed to a national stratified (by state) random sample of chiropractors. The analysis of data revealed that most chiropractors hold an undergraduate degree, practice in an urban area, are licensed to practice in only one state, belong to their state's chiropractic association, and are active in continuing education. Other data analyzed related to income, sources of new patients and average fees charged.

Murine fetal liver macrophages bind developing erythroblasts by a divalent cation-dependent hemagglutinin

During mammalian development the fetal liver plays an important role in hematopoiesis. Studies with the macrophage (M phi)-specific mAb F4/80 have revealed an extensive network of M phi plasma membranes interspersed between developing erythroid cells in fetal liver. To investigate the interactions between erythroid cells and stromal M phi, we isolated hematopoietic cell clusters from embryonic day-14 murine fetal liver by collagenase digestion and adherence. Clusters of erythroid cells adhered to glass mainly via M phi, 94% of which bound 19 +/- 11 erythroblasts (Eb) per cell. Bound Eb proliferated vigorously on the surface of fetal liver M phi, with little evidence of ingestion. The M phi could be stripped of their associated Eb and the clusters then reconstituted by incubation with Eb in the presence of divalent cations. The interaction required less Ca++ than Mg++, 100 vs. 250 microM for half-maximal binding, and was mediated by a trypsin-sensitive hemagglutinin on the M phi surface. After trypsin treatment fetal liver M phi recovered the ability to bind Eb and this process could be selectively inhibited by cycloheximide. Inhibition tests showed that the Eb receptor differs from known M phi plasma membrane receptors and fetal liver M phi did not bind sheep erythrocytes, a ligand for a distinct M phi hemagglutinin. We propose that fetal liver M phi interact with developing erythroid cells by a novel nonphagocytic surface hemagglutinin which is specific for a ligand found on Eb and not on mature red cells.

Primary bone tumours of the hand. Report of 21 cases

Twenty-one primary bone tumours of the hand in children from 8 paediatric hospitals are reported. Osteochondromas and enchondromas were not included. Our material consisted of 16 patients with common tumours (3 Ewing's sarcoma, 5 aneurysmal bone cyst, 6 osteoid osteoma and 2 epidermoid cyst) and 5 patients with uncommon tumours (osteoma, simple bone cyst, haemangiopericytoma, capillary angiomatous tumour and benign ossifying fibroma or osteoblastoma). The X-ray diagnosis of the common tumours should have high concordance with histology, whereas that of uncommon tumours is much more difficult and uncertain. The characteristic features of Ewing's sarcoma are stressed as all our children with this tumour had a delayed diagnosis and a fatal outcome. Differential diagnosis with other short tubular bone lesions of the hand - specifically osteomyelitis - is discussed and the possibilities of microscopic diagnosis are stressed.

Novel cell surface adhesion receptors involved in interactions between stromal macrophages and haematopoietic cells

Immunocytochemical staining of tissues with the mouse macrophage-specific monoclonal antibody, F4/80, has shown that large numbers of stromal macrophages are present in adult and foetal haematopoietic tissues. Macrophage plasma membrane processes are seen to establish extensive associations with myeloid and erythroid cells in adult bone marrow and with developing erythroblasts in foetal liver, suggestive of local trophic interactions. To explore the nature of these interactions, methods were developed for isolation of resident bone marrow macrophages (RBMM) and foetal liver macrophages (FLM). Following collagenase digestion of bone marrow or foetal liver, clusters were obtained which were composed of one or more central macrophages surrounded by proliferating haematopoietic cells. After attachment of clusters to glass coverslips, adherent macrophages could be stripped free of haematopoietic cells by pipetting in the absence of divalent cations. The purified RBMM, but not FLM, expressed a novel haemagglutinin, which mediated binding, without ingestion, of large numbers of unopsonized sheep erythrocytes by a divalent cation-independent mechanism. In view of the possibility that this sheep erythrocyte receptor (SER) could interact with a homologous ligand on mouse bone marrow cells, its properties were examined. SER was found to be a lectin-like protein which recognized protease-resistant sialylated glycoconjugates on sheep erythrocytes. The expression of SER was restricted to certain stromal tissue macrophages and was low or absent on monocytes and macrophages obtained from serous cavities. High levels of SER could be induced on elicited peritoneal macrophages by cultivation in mouse serum and the induced receptor was found to mediate low-avidity binding of murine bone marrow cells with characteristics indistinguishable from those seen for binding of sheep erythrocytes. However, maximal binding of bone marrow cells to RBMM depended on a distinct, divalent cation-dependent adhesion system. Using erythroblasts as a ligand, FLM were selected to explore the properties and expression of this adhesion receptor, the erythroblast receptor (EbR). Similar to SER, EbR did not mediate ingestion, and was restricted in its expression to foetal and adult stromal tissue macrophages. Unlike SER, EbR activity was not affected by neuraminidase treatment of the ligand and the receptor was not induced on peritoneal macrophages cultured in mouse serum. EbR appears to be a novel cell adhesion receptor because it was unaffected by inhibitors of several previously described cell adhesion molecules, including the fibronectin receptor. Future studies will attempt to explore the f

Pregnancy and birth rates among sexually experienced US teenagers--1974, 1980, and 1983

We examined pregnancy rates and birth rates among United States teenagers aged 15 to 19 years in 1974, 1980, and 1983. Pregnancy rate refers to live births plus induced abortions per 1000 women; birth rate refers to live births per 1000 women. We present these rates for all teens aged 15 to 19 years and for teens aged 15 to 19 years who were sexually experienced. Data sources included National Center for Health Statistics birth records, Centers for Disease Control abortion surveillance reports, and Bureau of the Census population estimates. Sexual experience estimates came from national surveys of adolescent sexual behavior. Between 1974 and 1980, the pregnancy rate among all teens increased; the pregnancy rate among sexually experienced teens declined. From 1980 to 1983, the pregnancy rate declined among all teens and among sexually experienced teens. Birth rates among US teenagers (all teens and sexually experienced teens) declined between 1974 and 1983. Whereas the decline in the birth rate from 1974 to 1980 was primarily due to increased use of abortion, the decline from 1980 to 1983 related to the decrease in teenage pregnancies.

Use of high voltage pulsed galvanic stimulation for patients with levator ani syndrome

Levator ani syndrome is characterized by brief, intermittent pain and discomfort in the perirectal or rectal region that can be aggravated by sitting. Physical therapists are beginning to receive referrals for pain reduction in this patient population. The purpose of the study was to examine the use of high voltage pulsed galvanic stimulation (HVPGS) for reducing symptoms in patients with levator ani syndrome. A descriptive research design was used. Treatment consisted of one hour of HVPGS at a frequency of 120 Hz and at an intensity to the patient's maximum tolerance applied through a rectal probe. Results on 28 patients indicate that 50% had pain or symptom relief, or both, after an average of eight treatments. Those patients who were unresponsive to treatment had a primary diagnosis of irritable colon or were postsurgical. We are continuing to examine this treatment and will conduct follow-up examinations on those patients who obtained pain relief. Based on these preliminary results, we believe that HVPGS is an effective treatment for selected patients in this population.

Lymphocyte subpopulations and function in cystic fibrosis

Circulating lymphocytes subpopulations and their function have been studied in 25 young adults with cystic fibrosis (CF) and 25 normal controls. Mean absolute numbers of all lymphocyte subsets in the CF group were not significantly different from the controls. Antibody-dependent cell cytotoxicity was significantly higher in the CF patients who had Pseudomonas aeruginosa in their sputum compared with those who had not and compared with the normal controls. Within the CF group the numbers of B cells, total T cells and OKT4+ helper cells fell as percent predicted peak expiratory flow (PEF) declined and similar significant positive correlations were found between lymphocyte subsets and percent predicted body weight. Serum albumin levels also showed a positive correlation with total T lymphocyte numbers (p less than 0.05). In vitro lymphocyte proliferative responses to mitogen were not significantly different from the control group, but again correlated positively with body weight in the CF patients. This provides further evidence that immune function in CF patients may become impaired as pulmonary disease and nutritional status deteriorate.

A comparison of acetaminophen and rimantadine in the treatment of influenza A infection in children

Rimantadine was compared with acetaminophen in a double-blind randomly assigned therapeutic trial in 63 children presenting with influenzal symptoms. Forty-nine of the children were proven to have influenza A by culture on presentation. Forty-three of the cultures, 88%, were influenza A/H1N1 strains. Both drugs were well tolerated. Rimantadine lowered the amount of virus shed in the first 2 days after initiation of therapy. Clinical resolution of illness was not different between the two therapeutic modalities. In individuals who shed virus for 4 days, strains recovered on the last day were relatively resistant to rimantadine.

Family planning in Jordan: 1983 survey data

Data from the 1983 fertility survey in Jordan indicate that 26 percent of married women were using contraceptives, reflecting a very small relative increase in use in the seven years before the survey. Only 5 percent of nonusers stated that they desired to use a method. Other data from the same survey suggest a potential demand for contraception, for spacing as well as limiting births, among those not using. For example, many recent pregnancies were reported to be unplanned. Also, among nonusers who did not desire to use a method, many stated they did not desire to become pregnant, yet were exposed to the risk of pregnancy. A pool of potential users exists who can be considered in need of contraception (i.e., fecund, not pregnant or desiring pregnancy, and not using contraceptives)--20 percent of all currently married, childbearing-age women--who may become contraceptive users as attitudes toward contraception change.

Side effects and discontinuation of oral contraceptive use in southern Brazil

The subsequent contraceptive behaviour following reported side effects in users of oral contraceptives in the southern region of Brazil is examined in relation to discontinuation of pill use, changing to other methods, termination of contraceptive use, the role of the physician in influencing a woman's decision to discontinue pill use, and discontinuation according to the type of problem experienced.

In 2904 currently married women, aged 15–44, almost 75% reported that they had used the pill at some time, and of these 45.6% were still doing so. Women who reported problems with the pill were less likely to be current users (25%) than the women who did not (65%). However, overall contraceptive prevalence was about the same in both groups. Women who stop using oral contraceptives are more likely to be using traditional methods than women in the general population, especially if they want more children. Termination of pill use varies little according to the type of problem reported. Women with problems who sought medical attention were more likely to stop using the pill and so were women advised to stop by their physician, but the major factor affecting discontinuation was the reported experience of a problem.

Focal fatty liver lesions in alcoholic liver disease: a broadened spectrum of CT appearances

The CT examinations of 26 consecutive alcoholic patients with focal fatty infiltration of the liver were analyzed. Five different patterns of focal fatty infiltration were noted. In most alcoholic patients these appearances present no diagnostic problem and further confirmation can be obtained by repeating the CT scan within 1-2 weeks to see if interval resolution occurs following enforced abstinence. In select instances, more invasive and definitive procedures such as superselective angiography or liver biopsy may be necessary to differentiate these findings from other more serious diseases they may closely resemble, such as primary or secondary liver neoplasms.

Cesarean delivery in northeast region of Brazil, 1978-80

This study presents information on cesarean section rates for the last baby born to 1,746 women in Northeast Brazil between January 1978 and the date of a 1980 household survey. For hospital deliveries, the c-section rate is 19 per cent. Rates were highest in the major urban areas and lowest in rural areas. Within residence categories, the section rate was related directly to education, early prenatal care, and delivery in private hospitals.