Metabolism and bioconversion of chromene derivatives inAgeratina adenophora (Asteraceae)

Seedlings ofAgeratina adenophora accumulate the chromenes demethoxyencecalin, encecalin and demethylencecalin. More than 80% of the total chromenes within the seedling are confined to the leaves where they are stored within the mesophyll. Metabolism of the chromenes during development of the seedlings was subjected to analysis by high-performance liquid chromatography. The accumulation kinetics obtained, as well as feeding experiments with non-radioactive chromenes, showed the bioconversion of these compounds to proceed from demethoxyencecalin via hydroxylation yielding demethylencecalin, followed by methylation yielding encecalin. Inhibitor studies with glyphosate indicate that the chromenes arise from precursors derived from the shikimic-acid pathway.

Mechanisms of displacement discrimination with and without perceived movement

A nearby visual reference point improves displacement discrimination. This effect occurs regardless of the delay between successive displays. The delay can be varied from short delays (50 ms), where observers report perceived movement, to long delays (2,000 ms), where observers report no movement. The similarity of reference effects for such different delay conditions was investigated by testing the independence of reference and delay effects. The critical independence property is whether the spatial variables (displacement and separation from the visual reference) combine independently of the temporal variable (delay). This kind of independence did not hold for displacement discrimination at delays of 50 ms and 2,000 ms. A further experiment tested for the independence property at delays of 500 ms and 4,000 ms, where observers reported no perceived movement. For these longer delays, the property was satisfied. These results are discussed using the general concept of a psychophysical mechanism. Such a mechanism combines the effects of several stimulus variables into a single mediating representation. By this analysis, at least two mechanisms must mediate the reference effect on displacement discrimination, one for delays of 200 ms and less and another for delays of 500 ms and more.

Mechanisms of displacement discrimination with a visual reference

A nearby visual reference point facilitates displacement discrimination. For example, a nearby stationary point of light improves discriminating left or right displacement of a point by several fold. This reference effect interacts with the temporal characteristics of displacement. Discrimination thresholds rise with increases in the delay between the offset of the initial stimulus and the onset of the displaced stimulus. Moreover, the effect of a nearby reference point is larger with a long delay than with a short delay. This interaction was investigated using two nonexclusive hypotheses of the mediating mechanisms. A single-signal hypothesis specifies a single mediating mechanism that aggregates the effect of displacement and delay. A single-noise hypothesis specifies a single mediating mechanism that aggregates the effect of reference and delay. Each of these hypotheses predicts an equivalence property similar to the equivalent background principle of adaptation research. The equivalence required by the single-signal hypothesis was not satisfied, disconfirming the hypothesis. In contrast, the equivalence required by the single-noise hypothesis was satisfied. The equivalence was extended to delays where the reported judgment was of perceived position and not of perceived movement. The second result is compatible with displacement discrimination mechanisms that are the same function of displacement, whatever their other differences.

Diverse serologic response to rotavirus infection of infants in a single epidemic

Eight infants with onset of gastroenteritis occurring within a 32-day period were examined for stool rotavirus antigen and serum antibody response to rotavirus. Each infant presented evidence of rotavirus infection but no single test for rotavirus-specific antigen or antibody was positive for every infected individual. Rotavirus was identified in the stools of five infants; in the others rotavirus etiology was determined by a specific immune response only. The neutralizing antibody response to each of four human rotavirus serotypes and to bovine rotavirus Nebraska calf diarrhea virus ranged from totally negative to a specific response to up to four serotypes. Three originally seropositive infants each showed an increase in neutralizing antibody titer to two or more serotypes. However, two of five originally seronegative infants also developed antibody to two or more serotypes. No consistent pattern of responses to different serotypes was detected.

Frozen sections of bone biopsies in metabolic and other bone diseases

Frozen sections of bone trephine and needle biopsies can be satisfactorily cut in a standard cryostat and, when stained with haematoxylin and eosin, they enable a rapid diagnosis to be made in a wide range of metabolic bone disorders including Paget's disease, osteoporosis, osteomalacia, hyperparathyroidism and renal osteodystrophy. Neoplastic disease of bone may also be diagnosed using the same technique. A tissue diagnosis can be established within an hour of the biopsy being taken, instead of the 1-3 weeks required for resin section diagnosis, with a consequent potential saving in further costly biochemical and radiological investigations, a possible shortening of the patient's stay in hospital and earlier initiation of correct treatment. The method is quick, reliable and highly cost-effective; it is of particular value in laboratories with insufficient workload to justify the expenditure on specialized microtomes and reagents for resin embedding.

Evaluation of a paper-patch test for sweat chloride determination

This article evaluates a recently developed qualitative sweat patch test (SPT). A battery-powered stimulator with polymer pad electrodes is used to stimulate sweating, followed by the application of a paper patch which collects the sweat and shows color change on sweat chloride levels above 40 to 50 mEq/l. Our data consist of 66 patients with cystic fibrosis, 75 control subjects, and 37 relatives of patients with cystic fibrosis, excluding 22 subjects (11%) with insufficient sweat. There were no false-negative results among 66 patients with cystic fibrosis, and in the control group, 71 of 75 subjects gave negative results and the other four gave positive results. Of the 37 relatives, eight gave positive results; all of the eight subjects are parents of patients with cystic fibrosis. Our results indicate that SPT is useful and reliable when there is sufficient sweat. This portable and simple patch test may serve as an excellent screening test for cystic fibrosis.

Femoral head vitality at reoperation for femoral neck fracture complications

In seven patients suffering redisplacement, nonunion or segmental collapse after nailing of femoral neck fractures, subsequent changes in the vitality of the femoral head were studied with tetracycline labeling and 99mTc-MDP scintimetry. At reoperation (total hip arthroplasty), the femoral heads were extracted and sawn into slices which were then analyzed. Vitality before nailing was totally lacking (tetracycline labeling) in one case (nonunion), and in the remaining cases moderate reduction was seen, most pronounced in the apical part of the head. In all cases, scintimetry 1-2 weeks after nailing showed reduced femoral head uptake of 99mTc-MDP, but scintimetry some hours before reoperation showed increased femoral head uptake. Isotope analysis of the slices from the extracted femoral heads showed marked reduction of uptake in the apical part of the head, moderate reduction in the distal and anterior parts, and satisfactory uptake in the posterior part of the head and the foveal region, though with individual variations. It was concluded that there is a genuine increase in uptake (revascularization) later in the course in postoperatively avascular heads, and that the apical part of the femoral head sustains the most pronounced vascular damage in femoral neck fracture and is probably the slowest to revascularize.

Femoral anatomy described in cylindrical coordinates using computed tomography

A new method, which describes the femoral anatomy in terms of angles and distances is presented. Primary data are obtained from CT and reduced to cylindrical coordinates by a computer program. The approach yields rotational angles for the entire shaft and demonstrates the limitation of conventional measurements of the anteversion angle. The method is proposed as a generalized technique for measurement of rotation in orthopedic radiology.

Clinical comparison of bone scintigraphy with 99Tcm-DPD, 99Tcm-HDP and 99Tcm-MDP

The bone-imaging agents MDP, DPD and HDP were compared radiochemically (only minor differences were found) in 12 patients with prostatic and 12 patients with breast carcinoma. Each patient received both MDP and either DPD or HDP. The scintigraphic examinations were compared visually and quantitatively. The uptake ratio normal bone/soft tissue was higher for DPD and HDP than for MDP. The ratio pathologic bone/normal bone was highest for MDP, particularly for prostatic carcinoma. The differences in this ratio for breast carcinoma were in general non-significant. The observed differences were minor and of little practical importance.

Arthritis in cystic fibrosis

We have confirmed previous observations of a transient, non-disabling recurrent arthritis in patients with cystic fibrosis. This arthritis differs from classic rheumatoid arthritis, is frequently associated with skin arthritis lesions, and its occurrence is unrelated to the severity of lung disease.

Technetium-99m-methylenediphosphonate scintimetry after femoral neck fracture. A three-year follow-up study

Thirty-nine patients with femoral neck fractures were followed up clinically and radiographically by technetium-99m-methylenediphosphonate (99mTc-MDP) scintimetry two to 20 days and four, eight, 12, 24, and 36 months after surgery or until redisplacement, pseudarthrosis, or segmental collapse occurred. The scintimetric data were calculated by selecting regions of interest on the fractured and intact sides over the femoral head, neck, greater trochanter, and shaft; ratios of fractured/intact side were obtained for each region. Bone metabolism after femoral neck fracture was expressed and analyzed numerically. Prognosis regarding the course of healing could be made with precision by studying femoral head isotope activity shortly after surgery, preferably one to three weeks after operation. Intact femoral head uptake (ratio greater than 1.0) was connected with uneventful healing, while defective uptake (ratio less than 1.0) was observed with healing complications. The vast majority of femoral heads with primary uptake defects showed increased uptake (greater than 1.0) after four months, often as early as six to eight weeks, indicating revascularization. Segmental collapse, as well as redisplacement and pseudarthrosis, appear to be related to femoral head vascular injury. Femoral head uptake in patients in whom healing complications developed secondary to avascularity differed significantly from that in patients with normal healing, except at investigations performed four to eight months after operation. 99mTc-MDP uptake in the femoral neck, trochanter, and shaft areas was increased for all femoral neck fractures. Subsequent normalization was considerably slower in patients with healing complications. A significant difference from normal healing did not occur until 12-24 months after operation. For patients with contralateral hip disease affecting the femoral head ratio, the prognosis regarding complications was made with the aid of the femoral head/shaft ratio on the fracture side.

Kinetics of 201Tl uptake in adenomas and well-differentiated carcinomas of the thyroid. A double isotope investigation with 99Tcm and 201Tl

A visually increased uptake of 201Tl chloride corresponding to a 'cold' (131I or 99Tcm ) thyroid nodule is mostly seen in well-differentiated carcinomas but also often in follicular adenomas. Since a visually increased uptake of 201Tl can be due to an increased initial uptake and/or a delayed elimination, an extended dynamic investigation was performed in patients with well-differentiated carcinomas or with follicular adenomas. Data were collected in a dynamic simultaneous double isotope ( 99Tcm + 201Tl) study up to 50 min after intravenous administration. Adenomas could be significantly separated from carcinomas by the elimination (p = 0.0001), but not by the initial uptake.

Infections in parenteral drug abusers. Further immunologic studies

In our previous study of soft tissue infections in parenteral drug abusers, two thirds of the infections were polymicrobial. Oral and enteric organisms were frequently recovered. These patients and a group of uninfected addicts showed frequent cutaneous anergy, lymphopenia, and hypergammaglobulinemia. An additional group of uninfected addicts was studied. The mean levels of IgA, IgG, and IgM were higher in the uninfected addicts. In the addict and control groups, elevations in IgA (17 percent of total), IgG (65 percent), and IgM (19 percent) levels were found. Zinc levels were within normal limits. T-cell populations below 70 percent were seen in five of the seven addicts and two of the four control subjects. Reversed helper to suppressor cell ratios were found in three of the seven addicts and control subjects. No consistent pattern of immunologic abnormalities emerged. The interrelationship of the abnormalities in the addict and their relationship to AIDS is unclear.

Pulmonary resection for complications of cystic fibrosis

Pulmonary sequelae account for a large proportion of the morbidity and mortality of cystic fibrosis. Bronchiectasis, hemoptysis, and abscess formation are often not responsive to conservative medical therapy. Pulmonary resection in selected cystic fibrosis patients is safe and therapeutically rewarding. Eleven pulmonary resections in ten patients with cystic fibrosis were performed. Patients ranged from 2.5 to 19 years of age. Indications for resection were: (1) abscess and bronchiectasis (nine patients), (2) atelectasis and mass (one patient), and (3) life-threatening hemorrhage (one patient). Surgical resection was employed only for medically refractory lesions which were life-threatening or contaminated otherwise functional lungs. Resection was limited to the most severely diseased areas, sparing functional lung parenchyma when possible. In this series, 9 lobectomies, 1 pneumonectomy, and 1 segmentectomy were performed. Preoperative management included aggressive chest physiotherapy and postural drainage, rigid bronchoscopic lavage, and broad-spectrum parenteral antibiotics. All patients were extubated in the operating room immediately postoperatively. Tracheostomy was not employed. There were no perioperative complications. All patients experienced subjective improvement. Objectively, improvement following surgical resection included: decreased cough and sputum production, and decreased incidence of exacerbations of pulmonary infections. Limited pulmonary resection when combined with intensive preoperative pulmonary toilet is a safe adjunct in the treatment of bronchiectasis and hemoptysis secondary to cystic fibrosis. Pulmonary resection should be limited to only severely destroyed lung parenchyma which is refractory to medical management. In contradistinction to other authors we have not found tracheostomy a necessary adjunct in surgical management.

Pregnancy in patients with cystic fibrosis

As more patients with cystic fibrosis reach adulthood, questions arise about the potential hazards of pregnancy. We reviewed the medical records of eight women with cystic fibrosis who had a total of 11 completed pregnancies and had been evaluated within 1 year before conception. In five women (Group 1), the overall maternal condition was little affected by the pregnancy, and in three women (Group 2), the mother's condition deteriorated during and after pregnancy and did not return to the pregravid state. With regard to pregravid status, significant differences between patients in Group 1 and Group 2 were found in Shwachman-Kulczycki clinical scores, weight for height values, Brasfield chest radiograph scores, and pulmonary function. A quantitative assessment of pregravid nutritional and pulmonary status is useful in counseling women with cystic fibrosis about the risk of pregnancy.

The Nb rat prostatic adenocarcinoma's dose response to methotrexate and adriamycin

The Noble rat prostatic adenocarcinoma, Nb-Pr-A.I.-II, an androgen-insensitive tumor, is the subject of this experiment. Dose responses were carried out with treatment of these tumors with three doses of adriamycin and two doses of methotrexate. Adriamycin treatment resulted in decreased tumor volume and decreased number of metastases in the higher dosage. Methotrexate also decreased metastasis and tumor volume. No animal treated with either of these agents in this protocol had the tumor undergo complete tumor regression, a criteria used in evaluation of chemotherapies with this animal model.

Ileal disease associated with spinal irradiation for ankylosing spondylitis

A case of ileitis, clinically resembling regional enteritis, but almost certainly due to previous spinal irradiation for ankylosing spondylitis is described.

Survey of the demographic characteristics of patients requiring restraints in a psychiatric emergency service

This paper examines the previously studied topic of the prevalence of uncontrollable behavior in psychiatric emergencies, using the need for restraints as an indicator, and seeks to discover demographic characteristics that were associated with patients needing restraints. The variables considered are sex, referral source, marital and financial status, race, education, diagnosis, age, and disposition. The findings of this survey were compared with those of another survey, which was conducted with a different population in a different community context, using tendency toward assault as an indicator of uncontrollable behavior. Although the two surveys were not strictly comparable, some interesting points were raised regarding differences and similarities.

Dog bites of the face: a 15 year review

Over a period of 15 years, 109 patients with 148 dog bites of the face were treated in one Plastic Surgery Unit. In this retrospective review the patterns of injury and treatment are defined with particular reference to specialised anatomical structures involved and the problems of repair. In this study, 87 patients (80%) were under 15 years of age.

Scintimetric evaluation of nailed femoral neck fractures with special reference to type of osteosynthesis

With the aid of Tc-MDP-scintimetry 1-2 weeks after nailing of femoral neck fractures, it is possible to distinguish fractures liable to complications. Due to the suspicion that frequent peroperative vascular damage was caused by the four-flanged nail (Rydell), a less traumatizing cylindric nail (Hansson) with an insertion instrument was used. In a prospective investigation in January 1981-February 1982, which included all intracapsular femoral neck fractures, the two above-mentioned methods of osteosynthesis were used randomly. Intravital staining with tetracycline showed the peroperative circulation equivalent in Rydell and Hansson groups. A significant difference in postoperative isotope uptake could be noted between the two groups in 37 patients with undisplaced fractures. In 34 of 45 displaced fractures in the Rydell group evidence of circulatory deficiency appeared in the postoperative scintimetry but in only 23 of 52 of the displaced fractures in the Hansson group, a statistically significant difference. The latter figure corresponds well to the incidence of peroperatively registered severe vascular injury evaluated by tetracycline labelling.

Comparative efficacy and tolerance study of azlocillin and carbenicillin in patients with cystic fibrosis: a double blind study

Azlocillin, a new acylureidopenicillin, has been compared to carbenicillin in a controlled, double-blind study for acute exacerbations of pulmonary infections in 29 patients with cystic fibrosis. Twenty-six patients were valid for final analysis of their therapeutic results; 12 treated with azlocillin (group I) at mean dosage of 252 mg/kg/day for a mean duration of 13.2 days of treatment, and 14 treated with carbenicillin (group II) at mean dosage of 505 mg/kg/day for a median duration of 12.6 days. Except for one patient of group I who had Staphylococcus aureus in sputum culture, the remaining patients all had Pseudomonas aeruginosa of mucoid colonial morphology with or without the same organism of rough variety in their sputum culture. Therapeutic efficacy was evaluated according to our scoring system of ten clinical factors, five radiological and five pulmonary function factors with 5 points each and 100 points total if perfect. The percentage of patients who improved by 20% or greater in clinical scores was found in 91.7% of patients in group I and 64.3% of patients in group II, which was statistically significantly different. The percentage of patients who improved by 20% or greater in total scores was found in 80% of group I and 45.5% of group II patients, which was less significant than the evaluation of clinical scores alone. Azlocillin was well tolerated and safe in the dosage employed. Its optimal dosage for patients with cystic fibrosis should be established.