Expression of the multifunctional extracellular matrix protein thrombospondin in crescentic glomerulonephritis

Thrombospondin is a multifunctional 450 kD glycoprotein which may be secreted into the extracellular matrix by a wide variety of cells. Occasional foci of immunoreactive thrombospondin have previously been demonstrated within normal human glomeruli. A specific polyclonal antibody directed against thrombospondin 1 was used to examine the distribution of this regulatory glycoprotein in renal biopsies from patients with a variety of renal diseases, including rapidly progressive glomerulonephritis associated with circulating antibodies to neutrophils, active or quiescent systemic lupus erythematosus, and membranous nephropathy, together with normal renal tissue. The results demonstrated the marked up-regulation of thrombospondin expression in acutely inflamed renal tissue with strongly positive, predominantly extracellular staining of glomerular crescents, although cytoplasmic staining of epithelial cells was also seen, indicating that these cells may contribute to thrombospondin accumulation at these sites. Occasional segmental mesangial staining was seen in cases of active lupus and rapidly progressive glomerulonephritis, while some focal interstitial staining around peritubular capillaries was seen in all renal tissue examined. These results suggest that thrombospondin may play an important role in the regulation of cellular recruitment, proliferation, and function in crescentic glomerulonephritis.

Use of enhanced chemiluminescence to quantify protein adsorption to calcium phosphate materials and microcarrier beads

The adsorption of serum proteins to calcium phosphate bone substitute materials, positively-charged dextrose and negatively-charged polystyrene microcarrier beads was compared by SDS-PAGE (sodium dodecyl sulphate-polyacrylamide gel electrophoresis). Protein adsorption to hydroxyapatite (HA)-based materials was influenced by chemical composition. Surface charge sign, distribution and/or functional group affected protein adsorption to microcarrier beads. Enhanced chemiluminescence was used to quantify adsorption of fibronectin and vitronectin following Western blotting, and to monitor the kinetics of adsorption of these two proteins to HA and Biosilon. Relative to total protein, fluctuating levels of fibronectin were detected on both materials. In contrast, vitronectin adsorption increased over the course of the incubation period with maximal relative adsorption detected after 30 min on Biosilon and 60 min on HA.

Ground Rubber Tire / Thermoplastic Composites: Effect of Different Ground Rubber Tires

Thermoplastic composites containing different Ground Rubber Tire (GRT) materials, Linear Low Density Polyethylene (LLDPE) and, in some case, a coupling agent (IB‘E’, an ethylene glycidyl methacrylate copolymer) were prepared by melt blending. The impact energies of all the thermoplastic composites (normally containing 40 wt % GRT) were evaluated using an instrumented impact tester. The effects of the GRT particle-size, particle size distribution and shape, the mode of grinding, and the oxygen surface concentration were analyzed. The wet-ambient-ground GRT based composites show higher surface oxidation and give better impact energy than cryo-ground and normal air-ground GRT based composites. Smaller GRT particle size results in a small increase in the impact property of the composite and a greater influence on the melt processability of the composites. Of the different GRT surface modification techniques studied for improved composite interfacial adhesion and impact properties the composites from electron beam radiation treated GRT yield higher increases in impact energy in comparison to corona and plasma treated GRT based composites.

Keeping the Faith: Religion in the Healing of Phobic Anxiety

1. Change invariably occurs following a crisis, which enables a new paradigm to be adopted. 2. Religious faith may be one possible paradigm that may be of benefit to patients. 3. Nurses have a responsibility to explore this untapped potential with their patients. 4. A patient with severe phobic anxiety who made a sustained positive response to becoming a Christian is described.

A major positive regulatory region located far upstream of the human alpha-globin gene locus

We have identified a remote, tissue-specific, positive regulatory element that is of major importance in determining the level of human alpha-globin gene expression. Stable transformants containing this DNA segment linked to the alpha gene in mouse erythroleukemia cells expressed human alpha mRNA at levels that are indistinguishable from those seen in interspecific hybrids containing the human alpha genes in their normal context on chromosome 16. Furthermore, all transgenic mice containing the alpha genes linked to this region expressed alpha-globin mRNA at high levels in erythroid tissues; and in one such mouse, readily detectable levels of human alpha-globin chains could be demonstrated in the peripheral blood. There is considerable similarity in the position, structure, and function of this region upstream of the alpha-globin complex with previously described elements within the beta-globin dominant control region (DCR). This is m marked contrast to other structural and functional differences between the two gene clusters. It seems likely that these critical, positive regulatory regions might provide target sequences through which coordinate regulation of the alpha- and beta-like globin genes is achieved.

Alpha-thalassemia caused by a large (62 kb) deletion upstream of the human alpha globin gene cluster

We describe a family in which alpha-thalassemia occurs in association with a deletion of 62 kilobases from a region upstream of the alpha globin genes. DNA sequence analysis has shown that the transcription units of both alpha genes downstream of this deletion are normal. Nevertheless, they fail to direct alpha globin synthesis in an interspecific hybrid containing the abnormal (alpha alpha)RA chromosome. It seems probable that previously unidentified positive regulatory sequences analogous to those detected in a corresponding position of the human beta globin cluster are removed by this deletion.

Nonsurgical aesthetic alteration of the eyelids in pathological conditions

This study examines the potential value of camouflage and corrective make-up techniques in treating certain pathological eyelid conditions associated with cosmetic imperfections to determine whether surgery might be avoided. As well, these same techniques have been found to enhance postoperative results. The conclusions support the use of camouflage make-up and suggest the value of the combined expertise of the oculoplastic surgeon and clinical cosmetician.

The role of metoclopramide in acute and delayed chemotherapy induced emesis: a randomised double blind trial

High dose metoclopramide is an effective anti-emetic for use with cisplatin containing chemotherapy regimens but can cause extrapyramidal reactions. Lorazepam and dexamethasone are increasingly being used to alleviate chemotherapy induced emesis. This trial has assessed the contribution of high dose metoclopramide to anti-emetic control when given with dexamethasone and lorazepam. Eight-one patients receiving chemotherapy, mainly for gynaecological malignancy, entered a randomised double blind cross-over trial comparing dexamethasone and lorazepam with or without a 24 h metoclopramide infusion. This was followed by oral dexamethasone with or without oral metoclopramide for three further days depending on the initial randomisation. Sixty-one patients were fully evaluable. Fifty-five received cisplatin containing regimens and six non-cisplatin regimens. There was a significant reduction in the number of episodes of vomiting during the first 24 h in patients receiving the metoclopramide combination (P = 0.0001). On first exposure to chemotherapy 45% of patients receiving dexamethasone, lorazepam and high dose metoclopramide had no vomiting while 67% had two episodes or less ('major control'). This compared to 11% total control and 25% major control in those receiving dexamethasone, lorazepam and placebo. The control of nausea in the first 24 h was also improved (P = 0.0001). There was no difference in the degree of nausea or vomiting during the following three weeks between those receiving oral dexamethasone alone and those receiving dexamethasone and metoclopramide. Both groups showed a significant increase in nausea in the three weeks following the second course of treatment when compared to the first (P = 0.0007). Extrapyramidal reactions were recorded in 11.5% of patients receiving metoclopramide. More patients stated a preference for the metoclopramide combination although this was not statistically significant (chi 2(1) = 0.29, P = 0.59). In conclusion the combination of dexamethasone and lorazepam can give major control of emesis in 25% of patients receiving very emetogenic chemotherapy. The addition of metoclopramide increases this to 67% on first exposure to chemotherapy, but at the expense of extrapyramidal reactions in 11.5%.

A prospective study of clozapine in treatment-resistant schizophrenic patients. I. Preliminary report

Preliminary results of a non-blinded prospective study of the effect of clozapine on symptomatology and social function in 51 treatment-resistant schizophrenic patients are reported. The mean duration of treatment at the time of this report was 10.3 +/- 8.1 months, median 7.6 months. Overall, 3/51 patients (60.8%) showed at least a 20% decrease in total BPRS, a criterion of improvement in the study of Kane et al. (1988). Four of 51 (7.8%) had at least a 50% decrease in total BPRS. Improvements in both positive and negative symptoms were noted. Marked improvements in social function were noted within the first 6 months of treatment. Improvement was first noted at all time points, with only 45.2% of improvers being identified after 6 weeks of treatment. These results suggest a 6-12-month trial may be desirable before deciding to discontinue clozapine because of insufficient response. Higher total Brief Psychiatric Rating Scale (BPRS) score and higher ratings on the Paranoid Disturbance subscales of the BPRS were factors which discriminated clozapine responders from non-responders.

A complex chromosome rearrangement resulting in trisomy 15q22 to qter

A black infant with malformations was found to have trisomy 15q22→qter. The mother had a complex chromosomal rearrangement involving three chromosomes (5, 13, and 15). A comparison with previously published cases of trisomy for distal 15q suggests a pattern of clinical findings including retardation in growth and development, microcephaly, asymmetrical facies, prominent occiput, antimongoloid slant of the palpebral fissures, micrognathia, prominent nose, and congenital heart disease.

Absent vestibulo-ocular reflexes and acute supratentorial lesions

Loss of vestibulo-ocular reflexes occurred in two patients with acute supratentorial lesions who received therapeutic doses of anticonvulsant drugs. There was no clinical or angiographic evidence of focal brain-stem damage. Absence of vestibulo-ocular reflexes is attributed to a combination of acute cerebral damage and anticonvulsant drugs. The loss of these reflexes in patients with acute cerebral lesions cannot be interpreted as evidence of irreversible brain-stem injury.

Idiopathic orthostatic hypotension treated with levodopa and MAO inhibitor: a preliminary report

The clinical and pathophysiological features of a case of idiopathic orthostatic hypotension (Shy-Drager syndrome) are presented. Recent reports on the pathological findings in this condition indicate that there may be a defect in catecholamine synthesis in the pigmented brain stem nuclei and sympathetic ganglia similar to that in idiopathic parkinsonism. On this basis a new form of therapy using levodopa combined with MAO inhibition is derived. The results of a trial of this therapy, which produced improvements in both the hypotension and in the extrapyramidal features of the disease, are reported.