Procedural cost accounting: a survival tactic

With the recent introduction of PPS and DRGs, nonprofit institutions in our industry have had to make major modifications in their methodology for fiscal soundness. One area that must be addressed is cost accounting and, more specifically, procedure cost accounting. Many hospital department managers have no formal training or education in cost accounting. Likewise, very few physicians receive cost-accounting training in their residency programs. Therefore, in the past, there has been little emphasis on this fiscal procedure. Cost accounting is the recording and classifying of the price paid for anything. The costs associated with a specific procedure are assembled into categories and compiled into a base figure with any additional indirect components or overhead costs taken into account. The resulting figure is then corrected for the institution's collection rate to assure complete recovery of all costs. This method is by no means the answer to every organization's needs; however, it is a starting place for managers. Radiology managers can improve upon this worksheet as their knowledge and understanding of the fiscal side of the hospital continues to grow. With more accurate methods for determining costs, managers can incorporate these into the process. The result will contribute to the final goal, a more efficient and cost effective operation.

Smooth muscle in the hepatic artery, portal vein and hepatic vein within the liver of the raccoon and guinea pig

The amount and arrangement of smooth muscle in the intrahepatic vessels suggests that the guinea pig would be a good animal model for studying mechanisms controlling intrahepatic portal vein blood flow, while the raccoon would be good for studying hepatic vein mechanisms of control.

Environmental and genetic factors that influence immunity and longevity in mice

Many different theoretical approaches may be taken toward understanding the association between aging and immunologic malfunction. The leading theory is based on the natural phenomenon of thymic involution and argues that the T-dependent lymphoid system is genetically programmed to decline in effectiveness, possibly through altered endocrine and central nervous system controls. The "thymic time clock" theory of aging is strongly supported by the consistent finding of defective cellular immunity functions in aged humans and animals and an associated development of the age-related diseases. In several animal models, including autoimmune-prone strains, high spontaneous tumor incidence strains, and normal long-lived strains, it has been possible to forestall the development of the major diseases of aging and extend longevity by restricting diet. The predominant effect of dietary restriction is prolongation of immunologic vigor and retardation of the immunologic dysfunction that normally occurs with age. Studies on environmental factors affecting longevity such as these and others which demonstrate a complex interaction between genes influencing longevity underscore the complexity and challenge of aging research.

Localization of transferrin receptor in the chorionic villi of complete molar pregnancy

Transferrin receptors have been identified on the villous trophoblast of normal chorionic villi by immunohistochemical techniques. The current study investigated the expression of transferrin receptors on molar chorionic villi by using a monoclonal antibody in immunofluorescence assays. The villous trophoblast of molar chorionic villi was brightly positive for transferrin receptor in the immunofluorescence assay. The presence of transferrin receptors on molar villous trophoblast may influence the immunologic relationship between molar and host tissues.

Localization of stage-specific embryonic antigens in hydatidiform mole, normal placenta, and gestational choriocarcinoma

Murine stage-specific embryonic antigens (SSEA-1, SSEA-3) are well characterized oncofetal antigens and have been identified in several human tumors. The current study was undertaken to determine the localization of SSEA-1 and SSEA-3 in hydatidiform mole, normal human placenta, and gestational choriocarcinoma. SSEA-3 did not react with any cellular components in hydatidiform moles, normal placentas, or choriocarcinoma cell lines. SSEA-1 was detectable in two human gestational choriocarcinoma cell lines, but not in the trophoblastic cells of 10 hydatidiform moles or in nine normal placentas between 6 weeks and term gestation. Therefore, according to this oncofetal marker system, the trophoblast in hydatidiform mole is more like normal trophoblast than gestational choriocarcinoma.

Immunobiology of molar pregnancy and gestational trophoblastic tumors

Because all the chromosomes in complete molar pregnancy are of paternal origin, complete moles are complete allografts (transplants). Complete moles may therefore be expected to induce a vigorous maternal host immunologic response. Further understanding of the relationships between the normal placenta, mole and choriocarcinoma may provide important insights into the basic mechanisms of teratogenesis and carcinogenesis.

Antagonism of the effects of midazolam on phrenic nerve activity in the dog by Ro 15-1788 and Ro 15-3505

Experiments were performed on 14 anaesthetized, artifically ventilated dogs, in which efferent activity in the phrenic nerve was recorded and blood-gas tensions, arterial pH and core temperature were controlled. Doses of midazolam between 0.2 mg kg-1 and 2 mg kg-1 abolished phrenic nerve activity for periods between 30 and 90 min. Ro 15-1788 in doses between 0.06 mg kg-1 and 1 mg kg-1 and Ro 15-3505 0.2-2 mg kg-1 reversed the effects of midazolam on phrenic nerve activity. Prior administration of these drugs either abolished or greatly inhibited the action of midazolam. When the preparations were observed for up to 2 h, there was no evidence of return of the action of midazolam, suggesting that both antagonists had a duration of action at least as long as that of midazolam.

Major histocompatibility antigens are not detectable on post-meiotic human testicular germ cells

Neither HLA Class I nor Class II transplantation antigens were detected on human testicular germ cells by immunohistologic or immunoprecipitation techniques. This unusual characteristic of human germ-line cells could help to explain their immunologically privileged status in potentially hostile autologous and allogeneic host environments.

Major histocompatibility antigens are not detectable on post-meiotic human testicular germ cells

Neither HLA Class I nor Class II transplantation antigens were detected on human testicular germ cells by immunohistologic or immunoprecipitation techniques. This unusual characteristic of human germ-line cells could help to explain their immunologically privileged status in potentially hostile autologous and allogeneic host environments.

Histocompatibility antigens (HLA-A,B,C) are not detectable in molar villous fluid

Cell-free villous fluid from healthy and necrotic molar villi did not contain detectable soluble HLA Class I (HLA-A,B,C) antigens; therefore, HLA sensitization of the maternal host is probably not attributable to shedding of HLA antigens by viable or degenerating HLA-positive stromal cells. The method developed for this study, a combination of immunoprecipitation and Western blot techniques, employed specific antibodies for positive identification of the HLA heavy chain. The pathogenesis of complete molar pregnancy may be better understood through further study of the mechanisms of HLA sensitization of the maternal host and the host's response to these foreign antigens.

Vestibulospinal reflexes as a function of microgravity

The idea that sustained microgravity will result in altered otolith input requiring a modification of postural control was explored by using the pathway that links the otolith organs and spinal motoneurons. Two related methods were used. First, the Hoffmann reflex was used to measure at specific times the excitability of the soleus-spinal motoneuron pool during a brief unexpected linear acceleration. Second, extensive dynamic postural testing with a moving platform was done before and after flight. The Hoffmann reflex amplitude, reflecting otolith-modulated motoneuron sensitivity, was low in flight after adaptation, and its postflight potentiation may have been dependent on rate of adaptation. The strength of inflight motion sickness symptoms was related to postflight Hoffmann reflex amplitude. Dynamic posture tests showed significant deviations from the results obtained before flight. The strategy used for balance on the moving platform was modified, and the behavior of the subjects suggested a decrease in awareness of the direction and magnitude of the motion.

Protein diffusion coefficient measurements by laminar flow analysis: method and applications

Laminar flow in an open tube leads to solute band spreading. This process is opposed by radial diffusion. The translational diffusion coefficient of a solute can be calculated from the band dispersion, tube length, and flow rate. No calibration is necessary. A simple apparatus was used to measure the diffusion coefficients of several small solutes and 18 proteins. Most results were within +/- 10% of literature values. Each determination required 7-90 min, depending on the magnitude of the diffusion coefficient. The amount of protein needed was approximately 25 micrograms. The diffusion coefficient data were useful for the estimation of molecular weights.

A comparison of panic disorder and generalized anxiety disorder

Subjects from a family study who had panic disorder and generalized anxiety disorder were compared on the pattern of their symptoms, age and type of onset, personality characteristics, course of illness, and outcome. Subjects with generalized anxiety disorder were shown to have fewer autonomic symptoms and an earlier, more gradual onset. Their illness was also observed to have a more chronic course and a more favorable outcome, although these differences were not statistically significant. The validity of generalized anxiety disorder and panic disorder as discrete diagnostic entities is supported.

Diazepam and propranolol in panic disorder and agoraphobia

The response to diazepam and propranolol hydrochloride was compared in 21 patients who (with one exception) met DSM-III criteria for panic disorder and agoraphobia. Each drug was administered for two weeks in double-blind fashion according to a crossover design. The response to diazepam was significantly superior on all measures. By observer rating, 18 patients showed at least moderate improvement with diazepam compared with seven receiving propranolol. Panic attacks and phobic symptoms responded to diazepam, but not to propranolol. The results suggest that benzodiazepines constitute effective short-term treatment for these newly defined disorders.

A computer program for linear nonparametric and parametric identification of biological data

A computer program package for parametric ad nonparametric linear system identification of both static and dynamic biological data, written for an LSI-11 minicomputer with 28 K of memory, is described. The program has 11 possible commands including an instructional help command. A user can perform nonparametric spectral analysis and estimation of autocorrelation and partial autocorrelation functions of univariate data and estimate nonparametrically the transfer function and possibly an associated noise series of bivariate data. In addition, the commands provide the user the means to derive a parametric autoregressive moving average model for univariate data, to derive a parametric transfer function and noise model for bivariate data, and to perform several model evaluation tests such as pole-zero cancellation, examination of residual whiteness and uncorrelatedness with the input. The program, consisting of a main program and driver subroutine as well as six overlay segments, may be run interactively or automatically.

Parametric analysis of dynamic postural responses

A detailed theoretical understanding of postural control mechanisms must be preceded by careful quantification of both the deterministic and stochastic aspects of postural behavior of normal and abnormal subjects under various dynamic conditions. Toward this end, concise parametric transfer function plus noise models were derived for both shoulder and waist position data obtained by applying a linear anterior-posterior bandlimited pseudorandom disturbance to the base of support of human subjects. Model orders as well as model parameters were determined empirically. One advantage of this modeling procedure is the conciseness of the postural models, permitting easy statistical analysis of the data obtained under different dynamic conditions from many subjects. Model features, including pole and zero locations, from 6 normal subjects each tested on 5 consecutive days under 3 input amplitudes and eyes open and closed conditions are presented. The resulting transfer function models consist of only 1 or 2 poles near the integration position on the Z plane unit circle and 0 to 2 zeros. Locations of the poles indicate that the eyes closed responses are more oscillatory, less damped, and with higher gains than the eyes open responses. These transfer functions are similar to nonparametric ones of other authors. The noise model orders are also small. Their spectra are those of low pass systems. Also, the quantity and frequency range of the postural noise is positively related to the amplitude of platform motion as well as related to the presence or absence of vision.

Antisperm antibodies in mouse vasectomy sera react with embryonal teratocarcinoma

Sera from vasectomized BDF1 mice were tested by immunofluorescence and radioimmunoassay for antibodies reacting with sperm and the mouse teratocarcinoma cell lines F9 and PYS. Antibody titers to both sperm and F9 cells increased with time after vasectomy and were highest in long-term (15 to 30 mo) vasectomized animals. By immunofluorescence assay, 35% of long-term vs 10% of age-matched control mice had antisperm antibodies (p less than or equal to 0.01), 54% of vasectomized vs 21% of controls had antibodies reacting with F9 teratocarcinoma (p less than or equal to 0.01), and 5% of vasectomized vs no controls reacted to the PYS teratocarcinoma cell line. No sera from either group reacted with thymocytes or cultured fibroblasts from male 129/Sv mice (negative somatic cell controls). Kendall's rank order statistical correlation test showed a significant association (p less than or equal to 0.01) between individual responses to sperm and F9 cells. Absorption of positive sera with sperm removed both sperm and F9 reactivity, indicating that the F9 cell-reactive antibodies in vasectomy sera are directed against identical or immunologically cross-reactive antigens present on the surface of sperm and F9 embryonal teratocarcinoma. A combination of electrophoresis and nitrocellulose blotting techniques (Western blot analysis) revealed that sera from some vasectomized mice contain IgG antibodies that react with 50,000 and 150,000 dalton (approximately) antigen bands present in sperm and F9 extracts, but not in PYS or thymocyte extracts. It remains to be determined whether the teratocarcinoma antigens detected in this study are true embryonic antigens or germinal antigens (the F9 cell line may have originated from primordial germ cells in transplanted embryonic tissue). In either case, teratocarcinoma cell lines provide an abundant source of material for the further characterization of these autoantigenic molecules.

Mechanisms of integration of de novo-synthesized polypeptides into membranes: signal-recognition particle is required for integration into microsomal membranes of calcium ATPase and of lens MP26 but not of cytochrome b5

We have investigated the in vitro integration into dog pancreas microsomal membranes of three integral membrane proteins that were synthesized de novo in a wheat germ cell-free translation system: calcium ATPase of rabbit sarcoplasmic reticulum, MP26 of bovine lens fiber plasma membrane, and rat liver cytochrome b5. Biosynthetically these proteins show a common feature in that they are synthesized without a transient NH2-terminal signal sequence. Two of these proteins, ATPase and MP26, were shown to require the recently discovered signal-recognition particle (SRP) [Walter, P. & Blobel, G. (1982) Nature (London) 299, 691-698] for integration. By this criterion, therefore, they each contain at least one uncleaved signal sequence. Surprisingly, however, the uncleaved signal sequence(s) of these two proteins did not induce the characteristic SRP-mediated translation arrest that was previously shown for a cleaved signal sequence. Unlike ATPase and MP26, cytochrome b5 did not require SRP for integration into microsomal membrane. Thus, the distinction between an "insertion" sequence (specifying unassisted and opportunistic integration into any exposed membrane) and a "signal" sequence (directing integration into a specific membrane by a receptor-mediated mechanism) is a valid one. By assaying for SRP dependence, the two mechanisms of integration can now be experimentally distinguished.

Antisperm antibodies in mouse vasectomy sera react with embryonal teratocarcinoma

Sera from vasectomized BDF1 mice were tested by immunofluorescence and radioimmunoassay for antibodies reacting with sperm and the mouse teratocarcinoma cell lines F9 and PYS. Antibody titers to both sperm and F9 cells increased with time after vasectomy and were highest in long-term (15 to 30 mo) vasectomized animals. By immunofluorescence assay, 35% of long-term vs 10% of age-matched control mice had antisperm antibodies (p less than or equal to 0.01), 54% of vasectomized vs 21% of controls had antibodies reacting with F9 teratocarcinoma (p less than or equal to 0.01), and 5% of vasectomized vs no controls reacted to the PYS teratocarcinoma cell line. No sera from either group reacted with thymocytes or cultured fibroblasts from male 129/Sv mice (negative somatic cell controls). Kendall's rank order statistical correlation test showed a significant association (p less than or equal to 0.01) between individual responses to sperm and F9 cells. Absorption of positive sera with sperm removed both sperm and F9 reactivity, indicating that the F9 cell-reactive antibodies in vasectomy sera are directed against identical or immunologically cross-reactive antigens present on the surface of sperm and F9 embryonal teratocarcinoma. A combination of electrophoresis and nitrocellulose blotting techniques (Western blot analysis) revealed that sera from some vasectomized mice contain IgG antibodies that react with 50,000 and 150,000 dalton (approximately) antigen bands present in sperm and F9 extracts, but not in PYS or thymocyte extracts. It remains to be determined whether the teratocarcinoma antigens detected in this study are true embryonic antigens or germinal antigens (the F9 cell line may have originated from primordial germ cells in transplanted embryonic tissue). In either case, teratocarcinoma cell lines provide an abundant source of material for the further characterization of these autoantigenic molecules.