Changes at the glomerulo-tubular junction in renal transplants

We studied by microscopy 377 biopsies, nephrectomies, and necropsy kidneys from 123 human renal transplants. We discovered two common abnormalities of the renal corpuscle, both affecting the glomerulo-tubular junction. Adhesion of the tip of the glomerular tuft to the origin of the tubule, as reported in various non-transplant glomerulopathies, was seen in 197 specimens (52 per cent). This change was common in material showing acute or chronic vascular rejection and glomerulopathy, and was almost universal in transplants that had been in place for over 1 year. Another change at the glomerulo-tubular junction, not previously highlighted, consisted of an infiltrate of lymphocytes or neutrophil polymorphs into the epithelium at the tubular origin. This change was seen in 145 specimens (38 per cent) and was associated with cellular rejection and ascending infection. These changes are of importance because they show two responses of the kidney to injury that involve the glomerulo-tubular junction and thus suggest that this part of the kidney has some specific properties that have been largely neglected up to now.

The effect of age on the cyclical patterns of plasma LH, FSH, oestradiol and progesterone in women with regular menstrual cycles

Luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol and progesterone concentrations in plasma were obtained daily throughout the menstrual cycles of 94 regularly cycling women, aged between 24 and 50 years. Although mean LH concentrations changed little with advancing age, mean FSH concentrations were significantly (P less than 0.001) elevated from the age of 39 years. FSH concentrations in the oldest women studied (48-50 years) were approximately 3-fold greater than in the younger controls (women aged 23-35 years). LH concentrations rose slightly (P less than 0.05) during the last 5 years only. The increase in FSH concentration was not, however, uniform across the cycle, but was confined predominantly to the mid-follicular and post-ovulatory phases (i.e. those times in the normal menstrual cycle when circulating inhibin concentrations appear to be minimal). Despite the clear increases in FSH concentration, there was little alteration in the mean steroid profiles which remained within the normal fertile range throughout the last decade of reproductive life. The only exception to this was a small, transient, but significant (P less than 0.05) decrease in preovulatory oestradiol concentration between the ages of 36 and 38 years, which was followed by a transient increase (P less than 0.01) in oestradiol concentration between 39 and 44 years. However, no corresponding significant changes in mean progesterone concentrations were observed.

Hyperpigmentation in megaloblastic anemia

Hyperpigmentation of the hands and feet developed in a 65-year-old Korean woman who had undergone a total gastrectomy and esophagojejunostomy due to early gastric cancer 7 years previously. A diagnosis of megaloblastic anemia due to vitamin B12 deficiency was made. In the areas of pigmentation, there were abnormally large nuclei in the keratinocytes. All of these findings were reversible upon the administration of vitamin B12. Ultrastructurally, there were many intracytoplasmic desmosomes, numerous aggregated bundles of tonofilaments, and highly condensed keratohyalin granules. The pathophysiologic mechanism of vitamin B12 deficiency associated with pigmentary disturbances and change of nuclear size is discussed.

Glutathione depletion in the guinea pig and its effect on the acute cochlear toxicity of ethacrynic acid

There is controversy as to whether or not the acute cochlear toxicity of ethacrynic acid (EA) is dependent upon its metabolic conversion to EA-cysteine via conjugation with glutathione. In order to investigate this we examined the acute effects of EA on cochlear potentials in guinea pigs in which glutathione levels were decreased by prior administration of (+/-)-buthionine sulphoximine (BSO), an inhibitor of glutamylcysteine synthetase. First, we determined the effects of BSO on hepatic and renal glutathione levels in the guinea pig. Guinea pigs (pigmented animals of both sexes or male albino animals) were killed at intervals up to 72 hr after i.p. administration of 1.6 g kg-1 BSO. Livers, and also kidneys in the case of pigmented guinea pigs, were removed and total glutathione (GSH + GSSG) measured. Glutathione levels reached a nadir in the liver at 24-48 hr (11% of control) and in the kidneys at 24 hr (14% of control) after administration of BSO. Hepatic but not renal levels approached control values by 72 hr. There were no sex or strain differences. Pigmented guinea pigs were anaesthetised and their endocochlear potential and a.c. cochlear potential in response to a 4 kHz tone were measured using an intracochlear microelectrode. The depression of these potentials by i.v. administration of 60 mg kg-1 EA was not affected by administration of 1.6 g kg-1 BSO 24 hr earlier, despite profound depletion of glutathione. Also prior p.o. administration of N-acetyl-L-cysteine did not affect hepatic glutathione levels nor modify the toxicity of EA. These results suggest that the acute cochlear toxicity of EA is not altered by glutathione depletion, a finding which argues against a role for the metabolic activation of EA in its ototoxicity.

Trophoblastic giant cells of the mouse placenta as the site of proliferin synthesis

Proliferin (PLF) is a PRL-related glycoprotein secreted by a number of mouse cell lines and by minced mouse placenta. To further investigate the hormone-like characteristics of PLF, we have determined the site of PLF synthesis and storage in the placenta and its concentration in blood serum during pregnancy. By immunohistochemical staining and in situ hybridization PLF protein and messenger RNA (mRNA) were localized to the trophoblastic giant cells. Individual cells contained both PLF and placental lactogen II. Trophoblastic giant cells appear to secrete PLF into the circulation since PLF was found at levels up to 5 micrograms/ml in the serum of pregnant mice by RIA and at somewhat lower concentrations in the amniotic fluid. Moreover, the serum concentration of PLF during pregnancy varied directly with the level of PLF mRNA in the placenta and with the number of placentas per animal. These findings are consistent with the hypothesis that PLF is a placental hormone; its function is not known.

Role of mu 1-opiate receptors in supraspinal opiate analgesia: a microinjection study

Microinjection of opiates into either the periaqueductual gray, locus coeruleus, nucleus raphe magnus, or nucleus reticularis gigantocellularis elicits a profound naloxone-sensitive analgesia. mu-Opioid receptors have been implicated in supraspinal analgesia and studies from our laboratory have demonstrated the importance of the mu 1-receptor subtype. In an effort to examine the receptor subtypes responsible for opioid analgesia in specific brain regions, we examined dose-response relationships and naloxonazine sensitivity of morphine and two enkephalin derivatives in the above 4 brain regions. Both morphine and [D-Ser2,Leu5]enkephalin-Thr6 (DSLET) were effective analgesics in all regions examined. The poor affinity of DSLET for mu 2-receptors and of morphine for delta-receptors, combined with their similar, high affinity for mu 1-receptors, implied a mu 1-mechanism of action. The mu 1-selective antagonist naloxonazine effectively blocked the analgesic responses of both compounds in all regions. [D-Pen2,D-Pen5]enkephalin (DPDPE), a potent delta-ligand which does not interact with mu 1-receptors, did not elicit analgesia in either the periaqueductal gray or locus coeruleus at any dose tested. These results suggest that opiates and opioid peptides produce analgesia in these 4 brain regions through mu 1-receptors. The inactivity of DPDPE argues against a role for delta-receptors and the similar analgesic potencies of morphine and DSLET makes a significant role for mu 2-receptors unlikely.

Oligoclonal T lymphocytes in the cerebrospinal fluid of patients with multiple sclerosis

We have investigated the T cell populations in the cerebrospinal fluid (CSF) of chronic progressive multiple sclerosis (MS) patients. Individual T cells from the CSF and blood were cloned before expansion and their clonotypes were defined by analysis of rearranged T cell receptor beta chain and gamma chain genes. 87 T cell clones from blood and CSF of two patients with chronic progressive MS were examined for common TCR gene rearrangement patterns. In one patient, 18 of 28 CSF-derived T cell clones demonstrated common TCR gene rearrangements indicating oligoclonal T cell populations; in the blood, two patterns were found twice among 26 T cell clones. In another patient, 5 of 27 CSF-derived clones had common TCR gene rearrangement patterns. In contrast, no common beta chain rearrangement pattern was found among 67 T cell clones derived from the blood or CSF of a patient with subacute sclerosing panencephalitis, among 20 clones from the CSF of a patient with herpes zoster meningoencephalitis, or among 66 clones from a normal subject. A subject with atypical, fatal MS of 8-mo duration was also studied and did not have oligoclonal T cells in the CSF or blood. These results demonstrate that distinct oligoclonal T cell populations can be found in the CSF immune compartment of subjects with nonmalignant inflammatory disease and they can create a new avenue for the investigation of the specificity of the T cell response within the central nervous system.

Development of immunoreagents to ciliary zonules that react with protein components of elastic fiber microfibrils and with elastin-producing cells

We describe the generation of a monoclonal antibody library to ocular zonule components and the characterization of three monoclonal antibodies: 1) one specific for microfibrillar associated glycoprotein (MAGP), a component of both ocular zonules and microfibrils of elastin fibers, 2) an antibody to an as yet unidentified 70,000 dalton antigen that is present in abundance in the extracellular matrix (ECM) of elastin-producing cells, and 3) an antibody reacting with the 67000 dalton subunit of the elastin receptor. The presence of antigenic determinants common to the ocular zonule and elastic fiber microfibrils suggests that zonules, which can be obtained in relatively pure form, can provide a valuable resource for characterizing proteins common to both microfibrillar structures.

Proliferin secreted by cultured cells binds to mannose 6-phosphate receptors

Proliferin is a prolactin-related glycoprotein secreted by proliferating mouse cell lines and by mouse placenta. In an attempt to identify target sites for proliferin action, we looked for proliferin receptors in murine fetal and maternal tissues during pregnancy using proliferin purified from the conditioned medium of a constructed Chinese hamster ovary cell line carrying amplified copies of proliferin cDNA. Purified proliferin bound to membrane preparations from fetal or maternal liver and from placenta with a Kd of 1 to 2 nM. The amount of proliferin bound per microgram of membrane protein varied markedly during pregnancy; maximal binding to day 16 fetal liver membranes was approximately 25 times that to liver membranes from adult animals. Binding to fetal and maternal receptors was specifically and completely inhibited by mannose 6-phosphate, with half-maximal inhibition at 10 microM. Furthermore, non-glycosylated proliferin did not inhibit the binding of the glycosylated protein. A approximately 300 Kd proliferin receptor was purified from the liver of pregnant mice using a proliferin affinity column and elution with mannose 6-phosphate. This receptor reacted with antibodies directed against the rat cation-independent mannose 6-phosphate receptor. We conclude that 1) proliferin secreted by cultured cell binds to cation-independent mannose 6-phosphate receptors and therefore may be a lysosomal protein or targeted to lysosomes, and 2) the concentration or activity of mannose 6-phosphate receptors in murine fetal and maternal liver and in placenta is regulated during pregnancy.

Decreased erythrocyte nicotinamide adenine dinucleotide redox potential and abnormal pyridine nucleotide content in sickle cell disease

RBCs from individuals with sickle cell disease are more susceptible to oxidant damage. Because key antioxidant defense reactions are linked to the pyridine nucleotides nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), we tested the hypothesis that the RBC redox potential as manifested by the NADH/[NAD+ + NADH] and NADPH/[NADP+ + NADPH] ratios is decreased in sickle erythrocytes. Our data demonstrate that sickle RBCs have a significant decrease in the NADH/[NAD+ + NADH] ratio compared with normal RBCs (P less than .00005). Interestingly, sickle RBCs also had a significant increase in total NAD content compared with normal RBCs (P less than .00005). In contrast, although sickle RBCs had a significant increase in the total NADP content compared with normal RBCs (P less than .00005), sickle RBCs had no significant alteration in the NADPH/[NADP+ + NADPH] ratio. High reticulocyte controls demonstrated that these changes were not related to cell age. Thus, sickle RBCs have a decrease in NAD redox potential that may be a reflection of their increased oxidant sensitivity. The changes in these pyridine nucleotides may have further metabolic consequences for the sickle erythrocyte.

Spectrophotometric determination of oxidized and reduced pyridine nucleotides in erythrocytes using a single extraction procedure

Several methods are available for the extraction and quantitation of oxidized and reduced pyridine nucleotides in erythrocytes. Enzymatic methods, however, are complicated by the presence of hemoglobin, which causes oxidation of NADH and NADPH during extraction. Although hemoglobin-mediated oxidation can be prevented by the addition of reducing agents, these interfere with spectrophotometric cycling assays for these nucleotides. Therefore, we have developed a method for determining oxidized and reduced NAD and NADP in human erythrocytes using a single extract. Our extraction method eliminates the need for reducing agents and thus allows the use of a spectrophotometric cycling assay. Using this method, we obtained full recovery of all added nucleotides with both normal and reticulocyte-enriched red blood cells. Our method is suitable for the determination of NAD+, NADH, NADP+, and NADPH in normal human erythrocytes and in red cells from patients with hemolytic anemia with a higher proportion of reticulocytes.

Clonidine induced variations of plasma norepinephrine and blood pressure in essential hypertension

To assess the contribution of sympathetic outflow to blood pressure in patients with essential hypertension, clonidine induced variations of plasma norepinephrine, mean arterial pressure and the pulse rate three hours after a 300 μg dose of oral clonidine, an antihypertensive agent that decreases central sympathetic outflow, were studied.

Baseline and clonidine suppressed plasma norepinephrine levels were not significantly different between the normal controls and patients with essential hypertension. The average plasma norepinephrine level, mean arterial pressure and pulse rate were significantly decreased from the baseline value in both normal control and essential hypertension (p<.005). The depressor response to sympathetic inhibition after clonidine were exaggerated in significant proportion in patients with essential hypertension compared to normal control group.

Our study suggests that the pressor sensitivity to norepinephrine plays more important role than sympathetic overactivity in some patients with essential hypertension.

Functional gamma chain-associated T cell receptors on cerebrospinal fluid-derived natural killer-like T cell clones

We have derived 33 independent T cell clones from the cerebrospinal fluid (CSF) of a patient with subacute sclerosing panencephalitis using a single T cell cloning method. 6% (2 of 33) of these clones express the T cell receptor gamma (TCR-gamma) protein and are called CSF TCR-gamma clones. Phenotypic analyses of the CSF TCR-gamma clones indicate that they are WT-31-, CD3+, CD4-, and CD8-. The TCR-gamma protein exists on the cell surface as part of an 85-kD disulphide-linked dimer noncovalently associated with the CD3 polypeptides. The CSF TCR-gamma clones have NK-like activity that can be inhibited by anti-CD3 mAbs. Both CSF TCR-gamma clones proliferated in response to anti-CD3 mAbs coupled to Sepharose beads and/or IL-2. Furthermore, stimulation of one of these clones with anti-CD3 mAbs results in a rapid rise in intracellular calcium. These data suggest that T cells bearing the CD3-TCR-gamma protein complex are functional and play a role in the human immune response.

Base sequence-specific interactions of operator DNA fragments with the lambda-cro repressor coupled with changes in their conformations

The mechanism of interaction of the operator DNA with the lambda-cro repressor protein was investigated using proton n.m.r. and photo CIDNP. Three kinds of DNA duplexes, the lambda-OR3 17-mer, phi80-OR2 19-mer and CRP binding site 22-mer, were prepared, and all of their imino proton resonances of the complexes with lambda-cro were assigned to individual base pairs. By monitoring the assigned signals of the DNA fragments and lambda-cro, it was found that in the complex of lambda-cro with lambda-OR3, two subunits of the cro dimer bind to the right and left halves of the OR3, respectively, and the bidentate binding induces a structural distortion in the middle of the 17-mer. lambda-cro itself also undergoes a conformational change including loosening of the dimeric form. In the complex of lambda-cro with phi 80-OR2, which has a 6-bp sequence common to that of lambda-OR3, one subunit of the cro dimer seems to bind specifically to the common part. However, there is only a slight conformational change in the cro dimer. In the mixture of the CRP binding site 22-mer and lambda-cro, soft contact without any conformational change was observed between them.

Secretion of proliferin

Proliferin (PLF) is a member of the PRL-GH family whose mRNA has been detected in proliferating mouse cells in culture and in mouse placenta. Suspensions of murine placental tissue have been shown to produce PLF detectable by immunoprecipitation. Here we report that PLF is secreted as a heterogeneous glycoprotein by growing mouse cell lines and placental tissue and that the first 29 amino acids of the preprotein serve as a signal peptide. Placental PLF is immunologically distinguishable from the 2 previously described mouse placental lactogens.

Diverticular disease of the colon in Korea

This study is designed to determine the relative prevalence and characteristics of diverticular disease of the colon in Korea. We did a retrospective evaluation of 16,964 consecutive barium enemas performed at Koryo General Hospital between January 1971 and October 1986, and found 100 patients with diverticular disease of the colon. The results are as follows: 1) Colonic diverticula were found in 100 patients, and incidence of 0.59% in 16,964 consecutive barium enemas. The male to female ratio was 2.1:1. 2) Incidence rose with advancing age from 0.45% in the second decade to 2.5% in the seventh decade. 3) Patient age ranged from 19 to 77 years with more than 70% of the patients in the 5th, 6th and 7th decades. 4) The greater majority (81%) of the diverticular disease the right colon. 5) Fifty percent of the cases were classified as multiple diverticula. 6) The mean age of patients with right sided diverticula was 47.5 years and that of patients with left sided diverticula was 57.7 years. The mean age of single diverticular patients was 50.4 years and that of multiple diverticular patients was 48.4 year. 7) Associated diseases were hemorrhoids (18%), gall stones (12%) and previous appendectomy (11%). Among the 29 patients who had hemorrhoids and or a previous appendectomy, 28 of those had right sided diverticula.

Multiple myeloma in Korea--clinical analysis and treatment results in 61 cases

A clinical analysis was made of 61 cases of multiple myeloma diagnosed between January 1976 and June 1984 at Seoul National University Hospital using the criteria of the Southwest Oncology Group.

The following observations were made. 1) The major clinical problems at Initial presentation were bone pain(52%), anemia(20 %), renal impairment(11%), and infection(10%). 2) Clinical stages at presentation were stage I, 11%; stage II, 8%; and stage III, 81% of patients. Three(5%) of the patients in stage II and 18(31%) in stage III showed renal impairment with a serum creatinine ≥2.0 mg/dl. 3) Combination chemotherapy produced a response rate of 29% with melphalan and prednisone, and 40% with M2 protocol(among 14 and 20 evaluable patients respectively). Both regimens showed statistically significant survival difference between responders and non-responders(p <0.01). 4) The median survival of all patients was 13 months. 5)Age, calcium level, creatinine level, and performance status were important prognostic factors on survival.

Plasma apolipoproteins and lipids in normal persons and patients with hypertension

We measured apolipoprotein A (ApoA), apolipoprotein B (ApoB), and lipid levels in 115 hypertensive patients and 100 normal subjects in order to evaluate the risk of atherosclerotic heart disease in hypertensive patients. The hypertensive patients were divided into the following subgroups: blood pressure controlled (A) and uncontrolled hypertensive subgroup (B), and without complication (C) and with complication (D).

In the hypertensive group, the mean plasma ApoA, ApoB, total cholesterol, triglyceride and beta-lipoprotein (LpB) levels were significantly higher than in the normal control group. The plasma high density lipoprotein cholesterol (HDL-cholesterol) level was not significantly different between the hypertensive group and the normal control group. ApoB/A ratio in the hypertensive group was higher than in the normal control group, but the difference was not significant statistically.

In the hypertensive subgroups, plasma Apo A was higher in all the hypertensive subgroups compared to normal control group, but these differences were not statistically significant. In subgroup B, C and D, the plasma ApoB level increased significantly as compared to the normal control group, but not so in the subgroup A. All of the subgroups had significantly higher levels of triglyceride and LpB level than the normal control group. HLD cholesteol level of all of the subgroups did not show any significant difference as compared to the normal control group. In subgroup B, C and D, the ApoB/A ratio was not significantly different from the normal control group. In the subgroup A, ApoB/A ratio was lower than in the normal control group, this was not significant statistically. Between subgroup A and B, and subgroup C and D, all of the plasma lipids and apolipoproteins did not show significant differences.

Thus our results showed that ApoB, LpB and triglyceride, which are closely related to atherosclerotic heart disease, were significantly increased in any of hypertensive subgroups compared to the normal control group.

Dynamic behavior of the imino protons of the gamma OR3 17mer in H2O solution studied by high-resolution NMR

The imino proton resonances of gamma OR3 17mer in water were observed at 500 MHz with the time-shared Redfield pulse train. All of the 17 imino proton resonances could be assigned specifically to individual base pairs by utilizing the trace of NOE connectivities between the imino and adenine C2H protons and between imino protons themselves. AT1 and 17 showed abnormally high chemical shifts in comparison with the other AT pairs. On raising the temperature, broadening of the signal occurred in a sequential manner from the terminals except for AT10 and AT11, which were broadened at a lower temperature than GC12. The relaxation rates of the imino protons were measured by the inversion recovery method. The rates at higher temperatures represent the exchange rates of the imino protons. From the temperature dependences, activation energies of about 15 kcal/mol for the AT imino protons and 23-26 kcal/mol for the GC imino protons were obtained.

Safety of outpatient cardiac catheterizations

Since 1979 most of the cardiac catheterizations at the investigators' institution have been performed as outpatient procedures. All cardiac catheterizations performed over a 66-month period were analyzed. A total of 3,071 outpatient cardiac catheterizations (83% of all cardiac catheterizations) were performed. The percutaneous femoral technique was used in 98% of the procedures. Most patients (79%) had both right and left-sided cardiac catheterization and coronary angiography, which showed significant coronary artery disease (70.4%). Only 13.6% of the study results were normal. Thirty-four patients (1.1%) had major complications, including 4 deaths (0.13%). Seventy patients (2.3%) were admitted for observation only. More than 96% of all patients did not have a major complication and were discharged the same day. Thus, outpatient cardiac catheterization can be performed safely, with a potential reduction in hospital costs and better utilization of medical beds.

Exposed tyrosine residues of lambda cro repressor protein evidenced by nitration and photo CIDNP experiments

The tyrosine residues of lambda cro repressor were partially nitrated with tetranitromethane under mild conditions. After digestion by Achromobacter protease I, the extent of nitration was determined by HPLC and amino acid analysis. Tyr 26 was most easily nitrated and Tyr 51 followed it. Tyr 10 was resistant to nitration. By comparison of the proton magnetic resonance spectrum of the partially nitrated cro protein with the above result, the aromatic proton resonances of the tyrosine side chains could be assigned to individual tyrosine residues. The extent of nitration is parallel to the accessibility to a flavin dye as measured by photo CIDNP (chemically induced dynamic nuclear polarization).

Identification of proliferin mRNA and protein in mouse placenta

Proliferin is a recently described, prolactin-related protein whose mRNA appears in several murine cell lines during active growth. We have surveyed a number of mouse organs or tissues for the presence of mRNAs that hybridize to cloned proliferin cDNA. Of the tissues tested, only the placenta yielded proliferin-related mRNA. This placental RNA is about 1 kilobase in length, increases sharply between days 8 and 10 of pregnancy, and then gradually declines through day 18. It is more abundant in RNA extracted from the fetal, compared to the maternal, part of the placenta. From a cDNA plasmid library prepared from poly(A)+ placental RNA, two types of proliferin-related clones were isolated, differing in intensity of hybridization to proliferin cDNA. By nucleotide sequence analysis, a strongly hybridizing clone was found to be nearly identical to the proliferin cDNA clone isolated from a library prepared from mRNA of a growing mouse fibroblastic cell line. Using an antiserum prepared against a synthetic proliferin fusion protein, we show that proliferin is secreted as a glycoprotein by minced placental tissue and that it differs from mouse placental lactogen. We conclude that proliferin is a placental hormone that is synthesized in certain mouse cell lines during active growth. Its function during pregnancy and during the growth of cultured cells is presently unknown.

Photo CIDNP study on the complex formation of lambda cro protein with OR3

A photo CIDNP spectrum of lambda cro repressor protein showed that one of the three tyrosines and His 35 are quite accessible to the photosensitive dye. For the remaining two tyrosine residues one is slightly accessible, but the other is inaccessible. In comparison with the result of differential nitration at tyrosine side chains followed by the peptide analysis, it can be concluded that Tyr 26 is mostly exposed and Tyr 51 is slightly exposed on the surface of the cro dimer. On the addition of OR3 17mer, His 35 and Tyr 26 are no longer accessible to the dye, which indicates that they are involved in interaction. However, a similar phenomenon was observed by adding CAP binding site 22mer. The interaction mechanism will be discussed.

Abolition of the negative endocochlear potential as a consequence of the gentamicin-furosemide interaction

The DC endocochlear potential and the AC cochlear potential in response to a 4 kHz tone were recorded in pigmented guinea pigs before and during ototoxic damage induced by sequential administration of the aminoglycoside antibiotic, gentamicin, and the loop diuretic, furosemide. Within 4 h significant diminution of the amplitude of the AC cochlear potential was accompanied by an almost complete abolition of the negative diffusion potential revealed by either furosemide administration or terminal anoxia. Thus, one of the effects of this interaction appears to involve a reduction in the potassium permeability of the cochlear partitions.

Seroimmunity to poliomyelitis in hospital personnel

Neutralizing antibody titers to poliovirus type 1, 2 and 3 were examined in paired serum specimens obtained from 43 female hospital personnel and laboratory workers at Veterans General Hospital. Before vaccination, 23.2% of those studied did not have neutralizing antibodies to one or more types of poliovirus, and 4.6%, 13.9% and 7.0% lacked serum neutralizing antibodies to poliovirus type 1, 2 and 3, respectively. In a comparison of the serological responses evoked by oral poliovirus vaccine in the same persons, a striking difference in antibodies was shown in the geometric mean titers and no lack of antibodies was found after oral poliovaccine immunization. Therefore immunization with oral poliovirus vaccine should be considered in the future as to improved protection for such high risk people.

Carcinogenic agents in cigarette smoke and the influence of nitrate on their formation

The nitrate level of a nonfilter reference cigarette was elevated from 0.52% to 1.2, 1.8, 2.4 and 3.05%, respectively, by addition of sodium nitrate. Data from the mainstream smoke analyses of these cigarettes were compared. Yields of carbon monoxide and carbon dioxide were not significantly altered as a result of nitrate elevation. Tar, nicotine, benzo[a]pyrene (BaP) and catechol in mainstream smoke were reduced while yields of nitrogen oxides (NOx), volatile N-nitrosamines (VNA) and tobacco-specific N-nitrosamines (TSNA) were significantly increased. On the basis of previous bioassays with smoke condensates from high-nitrate cigarettes, it was expected that the cutaneous tumorigenicity of these tars would be reduced due to lower levels of BaP (and other carcinogenic PAH) and catechol. However, the total carcinogenic potential of whole smoke from high nitrate cigarettes is considered by us to be significantly increased due to the elevated yields of Nox, VNA and TSNA. The nitrosamines are regarded as a major group of carcinogens in tobacco smoke; the nitrogen oxides are the most important precursors for the endogenous formation of N-nitrosamines upon smoke inhalation. The findings of this model study support the recommendation that the nitrate content of tobacco products should be reduced.

Molecular interaction between riboflavin and salicylic acid derivatives in nonpolar solvents

The interaction of riboflavin-2',3',4',5'-tetrabutyrate (I) with salicylic acid (II), aspirin (acetylsalicylic acid, III), and salicylamide (IV) has been spectroscopically investigated to determine the binding mechanism. NMR and absorption spectra were measured in nonpolar solvents. The association constant K of the formation of complex was calculated from the absorption spectra. Compounds I and II form a 1:1 cyclic hydrogen-bonded dimer through the N-3 proton and the C-2 carbonyl oxygen of the isoalloxazine ring, and the carboxylic hydroxyl proton and carbonyl oxygen of II. Compounds I and III form a 1:1 cyclic hydrogen-bonded dimer by the same mode. Compound IV forms a 1:1 cyclic hydrogen-bonded dimer with I through the N-3 proton and the C-2 carbonyl oxygen of the isoalloxazine ring, and the amino proton and the carbonyl oxygen of IV. Salicylates produce marked changes in the absorption spectra of I. These spectral changes are attributed to the formation of the hydrogen-bonded dimer. It appeared that the strongest complex was formed with salicylic acid, a weaker one with aspirin, and an even weaker one with salicylamide.

On the formation of the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone during smoking

Tobacco-specific N-nitrosamines (TSNA) are the most abundant carcinogens identified in tobacco and its smoke. Reducing their levels in tobacco products and especially in cigarette smoke is, therefore, a primary goal towards minimizing the carcinogenic burden of the tobacco consumer. This study delineates the mechanisms of formation of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), the most powerful of the carcinogenic TSNA during cigarette smoking. It demonstrates, by means of radiolabeled tracer compounds that 6.9-11.0% of the NNK formed in tobacco during the curing process transfers into the mainstream smoke. This constitutes 26-37% of the NNK present in the smoke. Addition of [methyl-14C]-nicotine to cigarettes, prior to smoking, led to the finding that 0.001% of nicotine in the cigarette column appears in the smoke as NNK. Thus, 63-74% of NNK in smoke is formed during smoking. NNK yield in the smoke was independent of nitrate content of the tobacco. These data serve to devise methods of reducing TSNA in smoke.

Interaction between flavins and alcohols

The effect of alcohols on the spectral properties of riboflavin derivatives in non-polar solvent was studied by various spectroscopic methods in order to support the view point that alcohol may directly interact with the isoalloxazine moiety of FAD and enhance the catalytic activity of D-amino acid oxidase (DAAO). The most likely association complex between alcohol and riboflavin is 1 : 1 stoichiometric complex through the 3-N imino and the 2-C carbonyl groups of the isoalloxazine ring and the hydroxyl group of alcohols. It appears that methanol has a larger association constant than any other alcohols, and the association constant decreases with the increase in carbon number and with the steric requirement of the alkyl group of alcohols.

Three-dimensional digital subtraction angiography

A dye-edge tracking algorithm was used to determine the corresponding points in the two images (anterior-posterior and lateral) of the digital subtraction biplane angiography. This correspondence was used to reconstruct three-dimensional images of cerebral arteries in a dog experiment and a clinical observation. The method was tested by comparing the measured image of oblique view to the computed reconstructed image. For the present study, we have developed three new algorithms. The first algorithm is to determine the corresponding dye-edge points using the fact that the density of contrast media at the moving edge shows the same changing pattern in the two projection views. This moving pattern of dye-edge density is computed using a matching method of cross correlation for the two sequential frames' dye density. The second algorithm is for simplified perspective transformation, and the third is to identify the corresponding points using a complementary method for locating the approximate points on the small vessels. The present method can be applied to compute the velocity of blood flow using the dye-edge displacement and the three-dimensional distance data.

Late replication and recombination in the vegetative pool of T4

The rates and extents of replication are the same for all members of the vegetative pool, whether already residing (progeny) or newly entered (superinfecting). Thus, no member of the pool is sequestered in a replicative complex. Amber N82 infections of nonpermissive host result in extensive breakdown of phage DNA. The extent of fragmentation observed depends on the multiplicity of infection and whether phage ligase is present. Hence, parental DNA suffers single-strand nicks which can be repaired by ligase only if recombination does not interfere. The physiological role of ligase in compensating for such nicks is reemphasized. Superinfecting genomes recombine very rapidly with progeny molecules whose combined lengths are approximately six times that of the superinfecting genomic fragment. The superinfecting phage does not replicate before recombining. Therefore, the lack of replication poses no barrier to efficient recombination.

Noninvasive assessment of left ventricular function from the mitral valve echogram. Relation of final anterior mitral leaflet closing velocity to peak dp/dt and aortic velocity

Since final mitral valve (MV) closure and aortic ejection velocity are mediated by the same forces in early left ventricular (LV) contraction, the rate of final MV closure (BC slope) should reflect LV performance. We first verified whether peak final closing velocity (ds/dt) of the anterior MV leaflet (AMVL) is related to peak aortic ejection velocity (V) and LV dp/dt in 18 open-chest dogs. We then checked the validity of the relations in man. Our approach was to measure peak ds/dt, peak aortic acceleration (dV/dt) and peak LV dp/dt using electronic differentiation of analog signals of the AMVL echogram, V and LV pressure. In dogs, resting ds/dt averaged 26.9 +/- 9.0 (SD) cm/sec and changed significantly (P less than 0.001) after isoproterenol, propranolol, coronary ligation and aortic cross-clamping. We found good (P less than 0.001) correlations between ds/dt and V (r = 0.82), dV/dt ( r = 0.67) and dp/dt (r = 0.73). In man, resting ds/dt averaged 25.5 +/- 1.6 cm/sec in six normals. In 40 patients with coronary artery disease, restind ds/dt was lower (15.7 +/- 4.4 cm/sec; P less than 0.001) in the 19 with resting LV end-diastolic pressure (LVEDP) greater than 12 mm Hg. Resting ds/dt correlated closely with V (r = 0.82, N = 10), dp/dt (r = 0.93, N = 6), resting LVEDP (r = -0.67, N = 40), angiographic ejection fractions (r = 0.62, N = 40) as well as manually obtained BC slopes (r = 0.93, N = 40). Thus, final MV closing velocity provides a useful and simple means for the objective noninvasive assessment of LV performance.

Long-term survival after tricuspid valve replacement. Results with seven different prostheses

The experience with tricuspid valve replacement (TVR) with seven different prostheses, alone or combined with replacement of other valves, in 73 patients (64 rheumatic and nine nonrheumatic) between 1964 and March, 1975, at the University of Alberta Hospital has been reviewed. Early and late mortality rates in rheumatic patients were 41 and 23 percent, respectively (36 percent being alive after a mean of 5.6 years), compared to 33 and 11 percent, respectively, in the nonrheumatic patients (56 percent being alive after a mean of 2 years). Of all survivors, 88 percent were functionally improved. Among the rheumatic patients: (1) 88 percent had organic tricuspid disease; (2) of the 39 patients with tricuspid insufficiency who underwent corrective mitral surgery 7 years before TVR, the tricuspid insufficiency had progressed over the 7 years; (3) the number of patients with tricuspid insufficiency had increased (39 versus 59) over the same 7 year period; (4) a high early mortality rate was encountered in those who were preoperatively in New York Heart Association (N.Y.H.A.) Class IV, or who had cardiomegaly, or pulmonary hypertension, or poor ventricular function, or organic disease, or reoperation; (5) the percentages of survivors with different prostheses were: Starr-Edwards, 31 percent; Beall-Surgitool, 14 percent; Kay-Shiley, 46 percent, Björk-Shiley, 50 percent; Lillehei-Kaster, 100 percent; Cutter-Smeloff and Wada-Cutter, nil. Among the nonrheumatic patients, two with the Cutter-Smeloff, two with the Beall-Surgitool, and one with the Lillehei-Kaster were alive after 14, 37, and 15 months, respectively. Among all survivors of TVR, late thrombus and pannus developed on both ball and disc prostheses (Starr-Edwards, two; Cutter-Smeloff, one; Lillehei-Kaster, one). These findings suggest that TVR should be performed earlier in rheumatic patients to reduce the operative mortality rate and that the Lillehei-Kaster prosthesis is probably most suitable for TVR.

Application of step-wise discriminant analysis and Bayesian classification procedure in determining prognosis of acute myocardial infarction

A retrospective study was carried out to assess the feasibility of computer-assisted prognostication by discriminant analysis and the Bayesian classification procedure based on clinical information collected on patients with acute myocardial infarction. The overall accuracy was 94.2% in predicting hospital death but the prediction of late death after discharge was less accurate. It was found that not all of the 44 variables used for analysis were necessary to reach the same level of predictive accuracy--16 to 20 variables would result in almost the identical prediction. The Bayesian classification procedure was applied to estimate probabilities of individual patients belonging to the different prognostic categories.

Echocardiographic measurement of cardiac output using the mitral valve and aortic root echo

The current echo method for measuring cardiac output (CO) has various technical limitations and is based on the assumptions that the left ventricle is not dilated and that it contracts uniformly. We have taken a different approach to measuring CO by echo: CO = cross-sectional area of aortic root X left ventricular ejection time X mean aortic flow velocity X heart rate. Using the Fick method, 34 measurements of CO were made in patients with normal aortic and mitral valves, with simultaneous echo recordings from the aortic and mitral valves. The systolic closure slope of the anterior mitral valve leaflet was assumed to represent the mean aortic flow velocity. CO by Fick and the proposed echo method correlated well, both in patients with (r = 0.94) and those without (r = 0.87) asynergy and the overall correlation was strong (r = 0.90). Using the conventional echo and Fick methods, a much weaker association was found between the two measurements in those patients with asynergy (r = 0.44) as opposed to those without asynergy (r = 0.77).

Abolition of ischemic response to atrial pacing following aortocoronary bypass surgery

To determine the effect of successful aortocoronary bypass surgery (ACBS) on left ventricular (LV) function, the ischemic response to right atrial pacing (RAP) was studied in 22 angina patients before and 3.8 +/- 1.1 months after surgery. All patients were free of angina after ACBS and had at least one patent graft. Before ACBS, RAP induced angina in 15 patients (Group 1) but not in 7 patients (Group 2). After ACBS, no patient had angina with RAP despite the increased maximum rate of pacing. Post-pacing LV end-diastolic pressure (LVEDP) after ACBS decreased in Group 1 from 25 +/- 6 to 15 +/- 6 mm Hg (P less than 0.01), but not in Group 2. Changes in ejection fraction, cardiac output, resting LVEDP, or LVEDP after LV angiography were not significant in either group and were therefore not useful in evaluating the result of ACBS. However the ischemic response to right atrial pacing was abolished by successful aortocoronary bypass surgery, suggesting improved myocardial perfusion during stress.