Association between anterior and posterior keratoconus

BACKGROUND/METHODS

We studied a 53-year-old male patient, presenting with a history of reduced vision since childhood in the right eye and since birth in the left eye.

RESULTS

Ocular examination revealed the presence of anterior keratoconus in the right eye and posterior keratoconus in the left eye.

CONCLUSION

To our knowledge, co-occurrence of both varieties of keratoconus in the same patient has not been previously reported.

Imaging of the liver with helical CT: a survey of scanning techniques

OBJECTIVE

We conducted a survey of the members of the Society of Computed Body Tomography/Magnetic Resonance to assess current techniques in liver imaging using helical CT.

MATERIALS AND METHODS

The survey, which was designed to update earlier surveys from 1987 and 1993, included a questionnaire distributed to 77 members of the Society of Computed Body Tomography/Magnetic Resonance.

RESULTS

Forty-nine members responded, representing 28 institutions. In 1993, 19% (5/26) of institutions used helical scanners, compared with 82% (23/28) in 1996. The group of institutions with helical CT served as the focus of this survey. In 1993, 58% of institutions used 1-cm collimation: in 1996, 78% (18/23) used thinner, 7- to 8-mm collimation. In 1987, 41% used power injectors compared with 85% in 1993 and 100% in 1996. In 1996, monophasic injections were used by 96% (22/23) of institutions. In 1993, most institutions used a contrast material injection rate of 1.5-2.0 ml/sec; in 1996, most used a 2.5-3.0 ml/sec injection rate. In 1993, 96% of institutions used 125-150 ml of contrast material; in 1996, 57% (13/23) of institutions used 125-150 ml and 30% of institutions used less than 125 ml of contrast material. A delay time of 21-45 see was used by 83% of institutions in 1993, whereas in 1996, 83% (19/23) of institutions used a longer delay time of 50-80 sec. In 1996, 13% of institutions used an individual scan delay technology and all institutions performed multiphasic scanning of hypervascular lesions.

CONCLUSION

The availability of helical CT has changed radiologists' approach to liver imaging. The greatest effects of which are a more widespread use of power injectors, longer delay times, thinner collimation, increased contrast material injection rates, decreased contrast material volumes, and multiphasic scanning.

Epikeratoplasty for Keratoconus Using Manually Dissected Fresh Lenticules: 4-year Follow-up

BACKGROUND

Epikeratoplasty for keratoconus, in the absence of apical scarring, aims at reducing high irregular myopic astigmatism and provides an ectatic cornea with mechanical support.

METHODS

We performed epikeratoplasty on 11 keratoconic corneas using fresh or McCarey-Kaufman preserved, manually dissected donor lenticules. A disparity of 0.5 mm was maintained between the host and the donor. Patients with keratoconus having a preoperative spectacle-corrected visual acuity of less than 6/60 and intolerance to contact lens wear were included in this prospective study. Spectacle-corrected visual acuity, keratometry, and refraction were analyzed over a 4-year follow-up period.

RESULTS

Four year follow-up was completed on 10 eyes. Of these, 80% achieved a postoperative spectacle-corrected visual acuity of 6/12 or better. Average postoperative keratometry was 45.79 +/- 2.07 D and a decrease of 4.60 +/- 0.09 D was observed in refractive cylinder. Spherical equivalent showed a significant decrease in myopia of -4.35 +/- 0.26 D. Mean time to stabilization was 8 +/- 2.3 weeks. Epithelial defects occurred in three eyes; two were successfully treated by patching. One lenticule was removed due to graft infection following a persistent epithelial defect.

CONCLUSION

Epikeratoplasty for keratoconus is a useful procedure with good long-term visual acuity results and an early stabilizing period.

Evidence for alpha 2-adrenoceptor agonist activity of minoxidil

The present investigation was undertaken to study the mechanism of action of minoxidil using various smooth muscle preparations. Minoxidil (4.7 x 10(-6) M to 4.7 x 10(-4) M) produced a concentration-dependent inhibition of field stimulation-evoked responses in rat anococcygeus muscle and vas deferens. The inhibition produced by minoxidil was antagonized by yohimbine (2.5 x 10(-7) M). Minoxidil (1.4 x 10(-5) M to 4.7 x 10(-4) M) also produced a concentration-dependent relaxation in oestrogen-primed potassium chloride-depolarized rat uterus. These responses were blocked not only by yohimbine but also by glibenclamide (2.02 x 10(-8) M). Our results suggest that minoxidil possesses alpha 2-adrenoceptor agonist activity in addition to potassium-channel-opening activity.

Vitamin E status in protein energy malnutrition

Serum vitamin E and cholesterol concentrations were measured in 50 children with protein energy malnutrition (PEM) and results were compared with a group of 50 normal controls. Mean serum vitamin E concentration as well as vitamin E/cholesterol ratio were found to be reduced in children with PEM while their mean serum cholesterol level was not significantly different from the control group. Data suggest that the reduced levels of serum vitamin E in PEM may be a result of malnutrition per se.

Genetic mapping of genes regulating the thymus size in back-cross rats between the laboratory BUF/Mna strain and the MITE strain derived from the wild rat, Rattus norvegicus

The thymoma prone BUF/Mna (B) rat is a useful model for studying the genes responsible for thymus enlargement during the stage of young growth. Among the strains of rats, B rats have the largest thymuses at all stages of life. A locus, Ten-1, which contributes to thymus enlargement in back-cross (BC) rats between the B and WKY/NCrj (W) strains, was mapped on chromosome 1. To determine the precise location of the locus, ¿B x(B x MITE)F1¿ BC rats were generated by crossing the B strain with the inbred MITE (M) strain, which was established from captured, Japanese wild rats, and were examined by linkage study using polymerase chain reaction with 67 microsatellite markers. Linkages with thymus enlargement were found in genotypes of seven markers, BSIS, LSN, MYL2, IGF2, PBPC2, D1Mgh11, and D1MIt6, by chi2-test and Student's t-test, which confirmed the presence of the genetic locus associated with thymus enlargement, Ten-1, in this region. Paradoxically, a suppressive locus, Tsu-1, to thymus enlargement was also found on chromosome 3, showing linkages of phenotype of the small thymus with genotypes of SCN2A, CAT, D3MIt16, and D3MIt13. By analyses of MAPMAKER/EXP and MAPMAKER/QTL, Ten-1 was mapped at 4.6 cM proximal from IGF2 locus on chromosome 1 and Tsu-1 at 4.0 cM proximal from CAT locus on chromosome 3, respectively.

Mycotic keratitis in children: epidemiologic and microbiologic evaluation

PURPOSE

To evaluate the demographic features, clinical profile, and laboratory diagnosis in cases of mycotic keratitis in children.

METHODS

We retrospectively analyzed 211 cases of mycotic keratitis in children younger than 16 years over a 5-year period in a tertiary eye center. Culture-proven cases of fungal keratitis were reviewed.

RESULTS

Trauma was the most common predisposing factor (55.3%), followed by associated systemic illness (11.2%), previous ocular surgery (9.8%), and others. Corneal injury contaminated with vegetable matter was responsible for 60.5% of traumatic cases. Aspergillus species were the most frequent isolates (39.5%). Others included Fusarium (10.7%), Alternaria (10.2%), Curvularia (7.4%), and Penicillium (7%). A seasonal variation in the incidence of mycotic keratitis revealed a peak incidence in the months of September and October. One hundred sixty-two children (76.7%) cooperated for examination and scraping under topical anesthesia with or without sedation. General anesthesia for scraping was required in 49 (23%) of 211 children for corneal scraping. Gram stains of corneal scraping were positive for hyphal elements in 54.5% of cases, and potassium hydroxide wet-mount preparation was positive in 90.2% of cases.

CONCLUSIONS

This study highlights important risk factors and organisms responsible for mycotic keratitis in children.

Retroperitoneal laparoscopic management of urolithiasis

Laparoscopic retroperitoneal pyelolithomy (Lap PL) and ureterolithotomy (Lap UL) were performed in 20 and 24 patients, respectively. The average operating time was 61.4 minutes for Lap UL and 80.2 minutes for Lap PL. The conversion rate for Lap PL was 4 (20%) patients, and none of the Lap ULs required conversion. There were no major postoperative complications, except prolonged tube drainage in 2 patients, and the average hospital stay was 3.6 days.

Congenital incudostapedial malformation

A case of bilateral symmetrical conductive deafness in a 45 year old female is presented. Tympanotomy revealed an anomaly involving the incudostapedial complex. The case is reported both because of rarity and also the anomaly encountered makes it apparently unique.

A compartmental model of water radon contamination in the human body

A multicompartmental model is developed to simulate the biokinetics in the human body following the ingestion of an inert gas. It was assumed that 100% of the radon ingested appears in the stomach, from which it is transported through the body to different organs via the blood stream. Each of these organs absorbs and releases radon differently, and, amongst all, the fat retains radon for the longest time. To test the model, the information on elimination rates of 222Rn in expired breath was obtained from other experiments done at the University of Maine. The data included male and female participants with a wide range of ages and physical activity levels. The radiation doses in the different organs and tissues were computed. As was expected, the stomach sustained the maximum dose. In this study, the highest stomach dose to any volunteer was evaluated as 115 mSv y(-1).

Sustained stress and fixed interval performance

The effects of sustained stress on response rate and temporal patterning (quarter-life) of rats performing either a previously learned fixed-interval schedule (FI 60) or learning an FI 60 simultaneously with stress onset were determined. Rats lived 24 h/day in operant cages, where they earned all of their food via lever-pressing. During the stress portion of each experiment, one group of rats was able to avoid or escape signalled intermittent footshock (Avoidance/ Escape Group), a second group (Yoked) did not have control over shock termination, a third group never received shock (Control). Shock trials were presented around the clock at approximately 5-min intervals and the stress portion of each study lasted 1-2 weeks. We have previously reported that rats tolerate this paradigm well and avoid/escape 99% of the shock trials. In rats previously trained on the FI task, both rate of responding and quarter-life values were significantly decreased on the first day of stress for both the Avoidance/Escape and Yoked Groups. Food intakes and quarter-life values were not significantly different from the controls by stress Days 3 and 2, respectively. In the acquisition study, controls learned the F1 task by Day 4 as judged by quarter-life of responding. FI task acquisition was significantly impaired in stressed rats compared to controls, not reaching asymptotic performance until Day 9 of stress. There were no major differences between the 2 stress groups in either study. These data demonstrate that stress may impair both the rate and patterning of behavior, and suggest that this rodent paradigm may usefully model some aspects of the effects of stress in humans.

Bcl-2 prevents CD95 (Fas/APO-1)-induced degradation of lamin B and poly(ADP-ribose) polymerase and restores the NF-kappaB signaling pathway

In the study presented here, we investigated the possible interactions between CD95 (Fas/APO-1) and Bcl-2 by studying the effects of Bcl-2 on the modulation of cellular pathways activated by CD95 using HeLa cells as a model system. We report that stable expression of Bcl-2 in HeLa cells is associated with multiple phenotypic changes. Treatment of HeLa cells with anti-CD95 monoclonal antibody (mAb) resulted in preferential degradation of lamin B compared with lamins A and C. Significant lamin B degradation was detected as early as 1 h after anti-CD95 mAb treatment. In contrast, lamins A and C as well as actin remained unchanged until 4 h after treatment with anti-CD95 mAb, a time point that correlated with the period of DNA fragmentation. These results indicate that selective degradation of lamin B is an early cellular event in response to activation of the CD95 pathway and that it precedes DNA fragmentation. Overexpression of Bcl-2 resulted in prevention of lamin B degradation and DNA fragmentation into oligonucleosome fragments in response to the apoptotic signal by anti-CD95 mAb. In addition, in Bcl-2-overexpressing cells that were protected against apoptosis, anti-CD95 mAb-induced cleavage of poly(ADP-ribose) polymerase was completely blocked. Overexpression of Bcl-2 also resulted in restoration of the CD95-mediated signaling pathway involving activation of the transcription factor NF-kappaB (p50/RelA). These findings suggest that Bcl-2 prevents apoptosis in part by preventing the degradation of major nuclear polypeptides such as lamin B and poly(ADP-ribose) polymerase. In addition, our results demonstrate that CD95-mediated signaling involves activation of NF-kappaB (p50/RelA).

Retinopathy after solar eclipse, 1995

BACKGROUND

Visual damage following direct sighting of the solar eclipse is a well established clinical entity. In spite of warnings in the media, a number of people attempted to observe the solar eclipse. Consequently, some developed visual damage.

METHODS

Twenty-one patients were referred to the Solar Eclipse Cell at our centre. Their demographic and clinical features were evaluated.

RESULTS

Foveal findings correlated with the duration of exposure and frequency of watching the eclipse. Six patients had used protective devices for viewing the eclipse. More than 47% eyes had discernible fundus lesions.

CONCLUSION

Lasting visual damage can follow a solar retinal burn with little or no protection from the viewing devices. Prevention remains the best treatment and there is a need to educate the public in this regard.

Health and nutritional status of boys aged 6 to 12 years in a children observation home

One hundred and ninety two boys in the age group 6 to 12 years, living in a Children Observation Home in Delhi were studied for their nutritional status and morbidity profile. Body Mass Index (BMI), an age-independent index was used to grade the nutritional status according to which, 36.7% of the boys were found to be malnourished. Signs of specific nutritional deficiencies were observed in 13.5% of the boys. Morbidity in some form or the other was present in 148 (60%) boys. Skin disease was the commonest morbidity (31.7%), followed by diseases of the oral cavity (16.1%), acute respiratory infections (8.6%) and diseases of the ear (9.9%). Need for health promotional activities is stressed to reduce the morbidity and improve the health status of these children.

Alteration of peripheral blood lymphocyte subsets in essential hypertension

OBJECTIVE

To assess lymphocytic subpopulation by labelled monoclonal antibody technique in a small group of patients with untreated essential hypertension (EH) and to detect any alteration with control of blood pressure.

DESIGN

Prospective study with phenotypic estimation of lymphocytes at presentation and a minimum of two weeks after the control of blood pressure.

SETTING

Referral, tertiary care hospital.

PATIENTS

Group 1, normotensive controls (n = 10); group 2, mild to moderate essential hypertension (n = 10); group 3, severe (accelerated/malignant) hypertension (n = 10). All the secondary causes of hypertension were ruled out by a thorough history, physical examination and appropriate radiological and biochemical investigations.

TESTS

Venous blood samples, taken at entry and a minimum of two weeks after control of blood pressure, were analyzed by alkaline phosphatase antialkaline phosphatase (APAAP) antibody technique for CD4, CD3, CD8 and CD22. Peripheral lymphocytes were separated and cocultured with phytohemagglutinin (PHA) for 72 h and assayed for CD25 by the APAAP technique.

MAIN RESULTS

In untreated patients with EH (groups 2 and 3), there was a significant down regulation of CD3, and CD4 lymphocytes whereas the proportion of mature CD22 cells increased. In group 3 there was a significant down regulation of CD25 with PHA stimulation. A negative correlation was observed between CD25 and diastolic pressure upon pooling the results of groups 2 and 3. No significant alteration in these parameters was observed following control of blood pressure with drugs for up to two weeks.

CONCLUSION

In this small group of patients with untreated EH, a significant alteration in the lymphocytic repertoire was observed. Whether this will be found in large groups of hypertensives remains to be seen.

Topical fluconazole therapy of Candida keratitis

A prospective clinical trial of topical fluconazole solution (2 mg/ml) was undertaken in six consecutive eyes of microbiologically proven Candida keratitis with abscess formation. All eyes responded well to the medical therapy. Average duration required for healing was 22.6 +/- 2.3 days. The findings of our study suggest that topical fluconazole is a safe and effective antifungal drug for the management of Candida keratitis with deep abscess.

Mapping of two genetic loci, Ten-1 and Ten-2, associated with thymus enlargement in BUF/Mna rats

The thymoma-prone BUF/Mna rat is a useful model for human thymoma. Thymoma develops spontaneously in these rats at an incidence of nearly 100%. At pre-thymoma age, BUF/Mna rats have extremely large thymuses when compared with those of rats of the other strains, suggesting the presence of genes that regulate the thymus enlargement. We performed linkage study to identify the genetic loci associated with thymus enlargement in {(WKY/NCrj x BUF/Mna) F1 x BUF/Mna} backcross rats. Linkage study showed the significant associations between thymus size and markers on Chromosomes (Chrs) 1 and 13, suggesting the presence of two genes, Ten-1 and Ten-2, which regulate the thymus enlargement. Ten-1 was located between myosin light chain, muscle 2 (MYL2) and D1Mgh11 loci on Chr 1, and Ten-2 was located between synaptotagmin II (SYT2) and D13N2 loci on Chr 13.

Cell cycle-dependent modulation of telomerase activity in tumor cells

Telomerase is a ribonucleoprotein complex that is thought to add telomeric repeats onto the ends of chromosomes during the replicative phase of the cell cycle. We tested this hypothesis by arresting human tumor cell lines at different stages of the cell cycle. Induction of quiescence by serum deprivation did not affect telomerase activity. Cells arrested at the G1/S phase of the cell cycle showed similar levels of telomerase to asynchronous cultures; progression through the S phase was associated with increased telomerase activity. The highest level of telomerase activity was detected in S-phase cells. In contrast, cells arrested at G2/M phase of the cell cycle were almost devoid of telomerase activity. Diverse cell cycle blockers, including transforming growth factor beta1 and cytotoxic agents, also caused inhibition of telomerase activity. These results establish a direct link between telomerase activity and progression through the cell cycle.

Low level nitrogen laser therapy in pulmonary tuberculosis

We report a technique for treatment of pulmonary tuberculosis that has become resistant to traditional antibiotics. We introduce a needle into the lung that carries the N2 laser to the affected chest cavity. It is irradiated for 10 min and usually only one sitting is required. Clinical improvement occurred in 90% of the patients; 60% of the patients showed improvement on their X-rays. This technique is recommended as an adjuvant to traditional tuberculosis therapy.

Postoperative spindle cell nodule of the bladder: a diagnostic problem

A case of postoperative spindle cell nodule of the bladder is reported. Initial pathological analysis was interpreted as leiomyosarcoma for which the patient underwent radical cystectomy, but subsequent reviews were consistent with a postoperative spindle cell nodule. Recognition of this benign, yet rare lesion is of significant importance to urologists, pathologists, and to the patient who may undergo extensive surgical procedure unnecessarily.

Oxygen-dependent and -independent mechanisms of renal injury in experimental ascending pyelonephritis

Pyelonephritis is the most common urinary tract infection affecting females of all age groups. Despite concerted efforts the mechanism of renal injury in pyelonephritis is not clearly understood. In the present study we have made an attempt to characterise the mediators of inflammatory insult in an experimental model of ascending pyelonephritis. Mice infected with Escherichia coli O6:K13:H1 were sacrificed at 2, 7 and 14 days post-infection. Luminol-dependent chemiluminescence response, NADPH oxidase, acid phosphatase, beta-glucuronidase and N-acetyl-beta-D-glucosaminidase activities were monitored in circulating as well as renal phagocytic cells in order to determine the role of reactive oxygen species and lysosomal enzymes in genesis of renal injury. We have demonstrated that reactive oxygen species are generated at the initiation of infection and the levels increase progressively during the course of infection. While intracellular release of lysosomal enzymes was seen in all groups, extracellular release was primarily observed at 7 and 14 days post-infection only. The results indicate that while reactive oxygen species play a significant role in tissue injury during all stages of infection, lysosomal enzyme release in extracellular milieu augments tissue destruction at later stages only.

Molecular characterization of the Azotobacter vinelandii recF gene

The recF gene from Azotobacter vinelandii (Av) has been cloned by complementation in an Escherichia coli (Ec) recF mutant. The sequence of 1568 bp has been determined and analyzed. It showed an open reading frame of 1092 nt coding for a 364-amino-acid (aa) polypeptide. The comparison of the deduced aa sequence of the recF of Av with those of other bacteria has elicited the presence of the four conserved domains thought to be essential for RecF function. A transcriptional fusion of a DNA fragment containing the promoter sequence of recF with the lacZ gene of Ec was constructed and 3-4-fold enhancement of promoter activity was observed upon UV induction.

Therapeutic penetrating keratoplasty in nonhealing corneal ulcer

Results of penetrating keratoplasty in 443 eyes of 439 patients of active infective corneal ulcers, from a period of 10 years, were analyzed. All these eyes were proven refractory to maximal medical therapy for extended periods of time, in some cases more than 6 weeks. As the surgery was performed during the active stage, the outcome was not favorable functionally. Clinical cure was obtained, however, by therapeutic penetrating keratoplasty in all but 27 of these eyes. Of unsuccessful cases, 16 could be saved with additional medical therapy, two led to phthisis bulbi, and nine required repeat therapeutic penetrating keratoplasty. Complications encountered included disturbances in intraocular dynamics such as extrusion of the lens and vitreous during surgery, secondary rise of intraocular pressure leading to damage of the optic nerve, loss of the eye due to above factors, and reinfection. The anatomical success achieved was 97% with graft clarity of 2+ or more in 39% of eyes. Useful vision, ie, better than or equal to 6/60, was possible in 33% of eyes. Thus, therapeutic keratoplasty in refractory corneal ulcer still has scope in a Third-World country.

Linkage of the athymic nude locus with the myeloperoxidase locus in the rat

In rats of the BUF/Mna strain epithelial thymoma development is regulated by a single autosomal susceptible gene, Tsr-1. In pre-thymoma stage, BUF/Mna rats have extremely large thymuses, when compared with those of other strains of rats. The large thymus size of this strain is contributed by a thymus-enlargement gene, Ten-1. On the other hand, reduced thymus size and suppression of thymoma development were found in heterozygous BUF/Mna-rnu/+ rats. Linkage studies between RNU and microsatellite and restriction fragment length polymorphism markers in ([BUF/Mna-rnu/rnu x WKY/NCrj] F1 x WKY/NCrj)- and (WKY/NCrj x [BUF/Mna-rnu/rnu x WKY/NCrj] F1)- backcross rats have led to the localization of RNU on chromosome 10. The rat homolog of mouse Mpo (myeloperoxidase) was also assigned to the chromosome 10. The gene order on the chromosome was MYHSE (myosin heavy chain of embryonic skeletal muscle)--(1.0 centimorgan [cM])--SHBG (sex hormone-binding globulin)--(4.0 cM)--RNU (Rowett rat nude)--(10.0 cM)--MPO--(13.0 cM)--AEP (anion exchange protein). Conserved linkage of homologous loci mapped to rat chromosome 10 and mouse chromosome 11 supports the hypothesis that the RNU and MPO loci are rat homologs of the mouse nu and Mpo loci.

Time-resolved immunofluorometric assay and specimen storage conditions for measuring urinary gonadotropins

We optimized storage conditions and validated a sensitive immunofluorometric assay (IFMA) for urinary gonadotropins. Assay linearity and parallelism for luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was observed to 0.04 IU/L. Urinary LH and FSH were unaffected by changes of osmolarity from 0.5 to 3.0 mOsm/kg, and from pH 4.5 to 10.5. Serum and urine measurements of the hormones correlated well over a wide range of values: for LH, R2 = 0.94, P < 0.01; for FSH, R2 = 0.71, P < 0.01 (n = 304). Preservation of urine with glycerol (70 mL/L) and storage at -20 degrees C yielded > 80% recovery of LH and FSH after 51 weeks; this was comparable with recovery for acetone extracts of urine. Untreated urine showed loss of activity by 4 weeks of storage. Preserving urine specimens with glycerol is a simple method of storage for longitudinal study and compares favorably with acetone extraction. IFMAs can measure urinary gonadotropins reproducibly over a wide range of pH and osmotic conditions.

Time-resolved immunofluorometric assay and specimen storage conditions for measuring urinary gonadotropins

We optimized storage conditions and validated a sensitive immunofluorometric assay (IFMA) for urinary gonadotropins. Assay linearity and parallelism for luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was observed to 0.04 IU/L. Urinary LH and FSH were unaffected by changes of osmolarity from 0.5 to 3.0 mOsm/kg, and from pH 4.5 to 10.5. Serum and urine measurements of the hormones correlated well over a wide range of values: for LH, R2 = 0.94, P &lt; 0.01; for FSH, R2 = 0.71, P &lt; 0.01 (n = 304). Preservation of urine with glycerol (70 mL/L) and storage at -20 degrees C yielded &gt; 80% recovery of LH and FSH after 51 weeks; this was comparable with recovery for acetone extracts of urine. Untreated urine showed loss of activity by 4 weeks of storage. Preserving urine specimens with glycerol is a simple method of storage for longitudinal study and compares favorably with acetone extraction. IFMAs can measure urinary gonadotropins reproducibly over a wide range of pH and osmotic conditions.

Application of papaya latex-induced rat paw inflammation: model for evaluation of slowly acting antiarthritic drugs

Papaya latex-induced rat paw inflammation model for evaluating antiinflammatory activity has been developed and reported earlier. A number of drugs viz. aspirin, indomethacin, piroxicam, ibuprofen, prednisolone, levamisole, chloroquine, and boswellic acids showed antiinflammatory activity in this model. As the last three drugs showing the activity belonged to the group of slowly acting antiarthritic drugs, this present study was undertaken to study in detail the sensitivity of this model for slowly acting, clinically effective, antiarthritic drugs viz. chloroquine, levamisole, penicillamine, aurothioglucose, cyclophosphamide, and boswellic acids. These drugs are known to show no appreciable activity in the known models of inflammation and arthritis. All these drugs tested in three graded doses showed dose-related significant antiinflammatory activity in this model, whereas those drugs in the carrageenan model tested in similar doses showed insignificant activity. Aspirin employed as a reference standard showed significant activity in both the models. Thus the slowly acting antiarthritic drugs will be identified as those displaying significant activity in the papaya latex model and insignificant activity in the carrageenan model and to be aspirin-like by their significant activity in both the above models of inflammation.

Tetanus in Auckland: a preventable disease

AIMS

To determine the clinical features, management and outcome for patients admitted to hospital with tetanus in Auckland.

METHODS

Medical records of all patients with tetanus admitted to hospitals in Auckland between January 1982 and December 1992 were retrospectively reviewed.

RESULTS

Fifteen patients were admitted to hospital during the study period. All patients were more than 40 years old and no patient had a history of more than one tetanus toxoid immunisation before the injury presumed responsible for tetanus. Failure to consider the diagnosis led to delay in starting appropriate treatment in most patients. Eleven patients required mechanical ventilation. The median duration of hospital stay was 44 days. All patients survived.

CONCLUSIONS

Tetanus is rare in Auckland and almost exclusively affects those born before 1960 when universal childhood immunisation against tetanus was started. The disease causes significant morbidity which could be avoided by increased efforts to ensure that all persons have completed a full course of immunisation. Universal vaccination against tetanus with regular boosters to maintain immunity would also circumvent the problems encountered with postexposure tetanus prophylaxis.

Patients' intentions in primary care: relationship to physical and psychological symptoms, and their perception by general practitioners

A series of three studies of consecutive primary care patients examined their intentions when visiting a general practitioner (GP). In study 1, a principal, components analysis of responses to a specially-devised symptom check-list was used to form component-based scales on which patients' physical symptoms were scored. Apart from a modest association of cold symptoms with seeking simple explanation, physical symptoms were unrelated to intentions. By contrast, the level of psychological symptoms correlated with the desire for support from the GP. In study 2 this result was replicated and shown to be unaffected by the amount of support which patients already experienced from family and friends. In study 3, GPs were found to be able to detect at better than chance level which patients desired support, but they were insensitive to other intentions. The results indicate that a technique for the quantification of patients' intentions permits the formal investigation of important questions concerning primary care consultations.

Fibular shortening in poliomyelitis

This study arose from observation that in children will leg shortening from paralysis, the relationship between the tibia and fibula is disturbed. This article analyses 76 patients of post polio residual paralysis involving only one lower limb. Sixteen patients had fibular shortening. Several factors that interfere with fibular growth, i.e. anatomical continuity, soleus strength, abnormal forces at distal fibular physis, result in fibular shortening. Early the age at onset of paralysis, more is the fibular shortening which is associated with lateral wedging of distal tibial epiphysis, valgus at ankle, external torsion of tibia and genu valgus.

Studies on processing and refrigerated storage of 'Rista'

Effects of mutton fat levels, hot-boned versus cold-boned meat and manual versus machine mincing were studied on the quality of 'Rista'-a popular emulsion type ground meat product of Kashmir (India). Incorporation of lamb fat at 20% level was found optimum for processing Rista. Both pre-rigor and chilled (post-rigor) meat were utilised for product manufacture. Addition of 0·5% sodium tripolyphosphate improved product binding, texture and yield. All these effects were more pronounced in machine minced Rista samples processed from cold-boned lamb meat, as compared with hot-processed and hand minced product. Cooked Rista was stored in low density polyethylene bags (0·25 μm thickness) at 4 ± 1°C in satifactory condition for 4 days.

Antisense MAP-2 oligonucleotides induce changes in microtubule assembly and neuritic elongation in pre-existing neurites of rat cortical neurons

Microtubule-associated protein 2 (MAP-2) is an abundant component of the cytoskeleton present in dendrites and cell bodies of neurons of the CNS. To examine the biological function of MAP-2, two MAP-2 antisense (AS) oligonucleotides complementary to the 5' region of the rat MAP-2 cDNA were added to rat primary embryonic day 17-18 (E17-18) cultured cortical neurons 24 h after plating and neurite outgrowth and morphology studied. The treatment of primary cortical cultures with either of the two MAP-2 AS oligonucleotides resulted in decreased MAP-2 and reduction in the number of neuritic processes relative to the control or MAP-2 sense-treated cultures. By immunostaining and light microscopy the AS-treated neurons appeared smaller, more rounded, and less intensely stained for MAP-2 than the untreated or the MAP-2 sense-treated cultures. By electron microscopy disorganized microtubules and a reduction in the number of microtubules within neurites of the AS-treated cultures were observed. We conclude that MAP-2 continues to be required for microtubule spacing and stability within neurites once they have formed.

Nerve growth factor regulates the abundance and distribution of K+ channels in PC12 cells

We examined the effect of nerve growth factor (NGF) treatment on expression of a neuronal delayed rectifler K+ channel subtype, Kv2.1 (drk1), in PC12 cells. Anti-Kv2.1 antibodies recognized a single polypeptide population of M(r) = 132 kD in PC12 cell membranes, distinct from the more heterogeneous population found in adult rat brain. In response to NGF treatment, levels of Kv2.1 polypeptide in PC12 membranes increased fourfold. This increase in polypeptide levels could be seen within 12 h, and elevated levels were maintained for at least 6 d of continuous NGF treatment. RNase protection assays indicate that this increase in Kv2.1 protein occurs without an increase in steady state levels of Kv2.1 mRNA following NGF treatment. Immunofluorescent localization of the Kv2.1 polypeptide revealed plasma membrane-associated staining of cell bodies in both untreated and NGF-treated PC12 cells. In undifferentiated cells, intense staining is seen at sites of cell-cell and cell-substratum contact. In differentiated cells the most intense Kv2.1 staining is observed in neuritic growth cones. These studies show that in PC12 cells both the abundance and distribution of the Kv2.1 k+ channel are regulated by NGF, and suggest that PC12 cells provide a model for the selective expression of Kv2.1 in neuritic endings.

Suppression of the hypothalamic-pituitary-ovarian axis in normal women by glucocorticoids

To determine whether cortisol has an effect on hypothalamic-pituitary-gonadal function, we studied 11 eumenorrheic women in the early follicular phase of consecutive menstrual cycles by performing daytime 10-min blood sampling, one before and one during hydrocortisone administration. Daily blood sampling for gonadotropins and sex steroids was also performed. LH pulsations were determined by modification of a widely used threshold method and compared by paired t-testing. The LH interpulse interval was significantly prolonged (95 +/- 5 to 119 +/- 14 min; p = 0.001), and the mean LH pulse amplitude remained unchanged (1.3 +/- 0.1 and 1.5 +/- 0.2 mIU/ml) with glucocorticoid exposure. Mean estradiol was not altered (46 +/- 5 and 43 +/- 3 pg/ml), but mean LH and FSH from pooled serum aliquots were slightly but significantly reduced (2.6 +/- 0.2 to 2.2 +/- 0.2, 5.5 +/- 0.4 to 4.5 +/- 0.3 mIU/ml; p = 0.004, 0.012, respectively). Mean progesterone levels were also decreased (0.8 +/- 0.3 to 0.5 +/- 0.2 ng/ml; p = 0.011) in the presence of exogenous glucocorticoid. Twenty-four-hour urinary free cortisol levels confirmed a substantial increase in free cortisol excretion (74 +/- 10 to 305 +/- 50 micrograms/day; p = 0.001). These results demonstrate that cortisol can slow LH pulse frequency and, by inference, hypothalamic GnRH secretion, in a manner that appears independent of corticotropin releasing factor. Excess cortisol alone may therefore play a role in the development of stress-associated menstrual disturbances.

Interactions between the Escherichia coli cyclic AMP receptor protein and RNA polymerase at class II promoters

The effects of a number of mutations in crp have been measured at different cyclic AMP receptor protein (CRP)-dependent Class II promoters, where the CRP-binding site is centred around 41 1/2 base pairs upstream from the transcription start point. The amino acid substitutions HL159 and TA158 result in reduced CRP-dependent activation, but the reduction varies from one Class II promoter to another. Deletions in the C-terminus of the RNA polymerase alpha subunit suppress the effects of HL159 and TA158. The role of the C-terminus of alpha at these promoters is assessed. Other changes at E58, K52 and E96 affect CRP activity specifically at Class II promoters and their role is discussed.

Magnitude of acute respiratory infections in under five

A community-based study was carried out in a rural area of Delhi to measure the prevalence and incidence of acute respiratory infections among children below the age of 5 years. The prevalence of 12.1%, was similar in boys and girls and was seen to decline with age. The incidence of acute respiratory infections was 2.5 episodes per child per year; it was not different in boys and girls. There was a statistically significant decline in the incidence with age. Upper respiratory tract infections comprised 87.5% of total acute respiratory infection morbidity while lower respiratory tract infections were 12.5%. Both upper and lower respiratory tract infections declined with increasing age; while the former was similar among boys and girls, the incidence of latter was significantly greater in boys (0.4 episodes per year) as compared to girls (0.2 episodes per year). A total of 87.5% episodes were mild, 10.4% moderate and only 2.1% were severe. The results suggest that acute respiratory infections are a major community health problem and an acute respiratory infection control programme needs to be implemented urgently.

Okadaic acid induces early changes in microtubule-associated protein 2 and tau phosphorylation prior to neurodegeneration in cultured cortical neurons

Microtubules and their associated proteins play a prominent role in many physiological and morphological aspects of brain function. Abnormal deposition of the microtubule-associated proteins (MAPs), MAP2 and tau, is a prominent aspect of Alzheimer's disease. MAP2 and tau are heat-stable phosphoproteins subject to high rates of phosphorylation/dephosphorylation. The phosphorylation state of these proteins modulates their affinity for tubulin and thereby affects the structure of the neuronal cytoskeleton. The dinoflagellate toxin okadaic acid is a potent and specific inhibitor of protein phosphatases 1 and 2A. In cultured rat cortical neurons and a human neuroblastoma cell line (MSN), okadaic acid induces increased phosphorylation of MAP2 and tau concomitant with early changes in the neuronal cytoskeleton and ultimately leads to cell death. These results suggest that the diminished rate of MAP2 and tau dephosphorylation affects the stability of the neuronal cytoskeleton. The effect of okadaic acid was not restricted to neurons. Astrocytes stained with antibodies to glial fibrillary acidic protein (GFAP) showed increased GFAP staining and changes in astrocyte morphology from a flat shape to a stellate appearance with long processes.

The effect of non-mutagenic stress on liquid holding recovery in Escherichia coli AB2463

Previous work has shown that exposure to many non-mutagenic stresses causes greater UV resistance in Escherichia coli K12 via an error-free, excision repair-dependent process. Induction of the latter should enhance liquid holding recovery in the bacteria. The results in this paper show that this is the case and that the increased UV-resistance is due entirely to an increase in the capacity of the cells for DNA excision repair. The latter arises wholly or in part from an increase in the intracellular level of the key enzyme of the pathway, UvrABC endonuclease.

CSF-1 expression is upregulated in astrocyte cultures by IL-1 and TNF and affects microglial proliferation and morphology in organotypic cultures

Astrocytes produce factors that control the growth and differentiation of many cell types within the CNS as well as play a role in the generation of the immune response. The extent to which these two functions interact has received less attention. We now report that astrocyte cultures established from rat brain endogenously express mRNA and low levels of secreted biologically active protein for the monocyte growth and differentiation factor colony stimulating factor-1 (CSF-1). Exposure of astrocytes to interleukin-1 (IL-1) and/or tumor necrosis factor (TNF) upregulated the expression of CSF-1 mRNA and protein. Following treatment with 100 U/ml of TNF, IL-1, or TNF+IL-1, maximum CSF-1 mRNA expression was observed at 3 hr. In the presence of IL-1 an increase in biologically active CSF-1 was detected in the astrocyte conditioned medium at 6 hr. These data indicate that the expression of CSF-1 by astrocytes can be modulated by exposure to the cytokines IL-1 and TNF. To determine whether CSF-1 provides a mitogenic signal for microglia during development, mouse spinal cord organotypic cultures were exposed to recombinant mouse CSF-1 (rmCSF-1), resulting in proliferation of microglia by 7 days and an increase in the number of ramified microglia over ameboid microglia by 14 days.

Differential regulation of S-adenosylmethionine synthetase isozymes by gibberellic acid in dwarf pea epicotyls

Dwarf pea epicotyls contained a single activity peak of S-adenosylmethionine (AdoMet) synthetase (isozyme I). Gibberellic acid (GA3, 1 microM) induced two additional isozymes (II and III). Cycloheximide (20 microgram/ml) blocked the appearance of GA3-induced isozymes, suggesting that it is dependent on de novo protein synthesis. Conclusive proof was obtained by labelling the isozymes II and III with [35S]SO2-(4) in vivo. The purified 35S-labelled AdoMet synthetase isozymes (II, III) showed a single protein band that coincided with the single radioactive peak on SDS-PAGE. Molecular-sieve chromatography of the isozyme I from control dwarf pea epicotyls and three isozymes of GA3-treated epicotyls on Sepharose CL-6B showed a single activity peak with an identical molecular mass of 174 kDa for each isozyme. Analysis of purified AdoMet synthetase isozymes (I, II, III) on SDS-PAGE showed a single silver-stained protein band with a molecular mass of 87 kDa. This proved the dimeric nature of all the isozymes of AdoMet synthetase which could be physically separated by ion-exchange chromatography on DE-52. In vitro molecular hybridization of physically separated isozymes by NaCl-freeze-thaw treatment method revealed that the three isozymes (I, II, III) in GA3-treated dwarf pea epicotyls are formed through the random dimerization of two different species of enzyme subunits that differ in their net charge. Thus, the two flanking activity peaks (isozymes I, III) represent homodimers, while the middle activity peak (isozyme II) is a heterodimer. Apparently, the single isozyme I in control epicotyls is a product of one gene of AdoMet synthetase (SAM 1), while three isozymes in GA3-treated epicotyls are the product of two genes of AdoMet synthetase. We speculate that the differential regulation of AdoMet synthetase in GA3-treated epicotyls is achieved by the expression of an alternate gene of AdoMet synthetase (SAM 2).