Normal fertilization and development of frozen-thawed mouse oocytes: protective action of certain macromolecules

Freezing and thawing of mouse oocytes causes changes in the zona pellucida that reduce fertilization. The fertilization and development of oocytes were studied after freezing and thawing in media containing 1.5 M dimethylsulfoxide (DMSO) and various macromolecular supplements: BSA (Fraction V and crystalline), fetal calf serum (FCS), and polyvinyl alcohol (PVA). In conditions under which the fertilization rate of oocytes frozen in medium containing BSA was reduced, oocytes frozen in medium containing FCS were fertilized at rates approaching those of nonfrozen controls. Significantly fewer oocytes were fertilized after freezing in the presence of PVA than oocytes frozen in medium containing BSA or FCS. Fertilization of oocytes frozen in the presence of PVA was significantly increased when serum was included in the medium during dilution of the cryoprotectant. The in vitro and in vivo development of embryos obtained from frozen-thawed oocytes was independent of the macromolecular supplement used in the freezing medium and was similar to that of nonfrozen control oocytes. The results show that given the appropriate conditions for freezing and thawing, cryopreserved mouse oocytes undergo fertilization and development at rates similar to those for nonfrozen controls.

Specific tolerance to neural allografts induced with an antibody to the interleukin 2 receptor

Despite considerable evidence documenting the central nervous system as a site of immunological privilege, immune responses do occur within the brain and neural allografts between major histocompatibility complexes (MHC) and minor antigen incompatible rat strains may be rejected. The survival of completely MHC incompatible neural allografts has been found to be prolonged indefinitely after administration of a monoclonal antibody (mAb) to the interleukin 2 receptor (IL-2R) for 10 d after transplantation. Here we present evidence that rats with long-term surviving lateral ventricular neural allografts, after anti-IL-2R treatment, accept subsequent neural allografts from the same donor strain, placed in a peripheral nonprivileged site, but rapidly reject third-party grafts. Thus, treatment with a mAb to the p55 chain of the IL-2R has resulted in the specific acceptance of second grafts of fully allogeneic neural tissue. These results suggest that ongoing interaction between elements of the host immune system and alloantigen within the brain maintains the tolerant state and furthermore, that interruption of signaling through the IL-2R may be important in allospecific tolerance induction.

Preliminary pharmacokinetics and safety of 882C87 in patients with herpes zoster

882C87 [1-(beta-D-arabinofuranosyl)-5-propynyluracil] is a nucleoside analogue with potent and specific antiviral activity against varicella-zoster virus (VZV). The IC50 of 882C87 against VZV ranges from 0.6 to 3.8 microM. Potentially therapeutic plasma concentrations are readily achieved in humans; the pharmacokinetics have been previously evaluated in healthy young and elderly (> 65 years) volunteers following single oral doses of 50-400 mg. Thirty immunocompetent patients with localised herpes zoster were treated with 882C87. Groups of patients received 50 mg, 100 mg, or 200 mg tablets of 882C87 every 12 hours for 7 or 7.5 days (14 or 15 doses). Six patients in each group were over 60 years of age. Blood samples for determination of 882C87 concentrations were taken at entry, steady state, and during the elimination phase following the last dose. After the final doses of the 50 mg 100 mg, and 200 mg dosage regimens, the Cmax of 882C87 in patients over 60 years old was 7.7 +/- 3.1 microM, 12.6 +/- 3.5 microM, and 24.8 +/- 14.0 microM, respectively, and the AUCs 0-12 were 78.4 +/- 31.8 microM.hr, 137.5 +/- 22.8 microM.hr, and 272.5 +/- 170.5 microM.hr, respectively. Preliminary estimates of the elimination half-life ranged from 15.1 to 20.0 hr. These preliminary pharmacokinetic data confirmed good dose proportionality for AUC and Cmax with values between those predicted from single dose data in the young and those in elderly volunteers. The plasma concentration profiles at these doses were in excess of IC50 values and support the use of once- or twice-daily regimens in future studies of 882C87 in herpes zoster.

Effectiveness and duration of intramuscular antimotion sickness medications

Motion sickness inhibits gastric motility, making the oral route ineffective for medications. The intramuscular route is an effective alternative. The rotating chair was used to produce the M 111 level of motion sickness on the Graybiel Symptom Scale. The intramuscular medications given 30 minutes before rotation were compared with placebo (saline, 1 mL) for effectiveness and duration in increasing the number of tolerated head movements. Average placebo number of head movements was 294. Promethazine 25 mg increased head movements by 78% (P < .05), with a duration of 12 hours. Scopolamine 0.2 mg increased head movements by 91% (P < .05), with a duration of 4 hours. The effect of caffeine 250 mg and ephedrine 25 mg was not significant. When combined with scopolamine, ephedrine produced an 32% additive effect. Scopolamine 0.08 mg, 0.1 mg, and 0.2 mg and also promethazine 12.5 mg and 25 mg were significant (P < .05). Promethazine appears to be the drug of choice for intramuscular use because of a longer duration and a high level of effectiveness. Scopolamine was of high effectiveness, but had a duration of 4 hours. It was eight times as potent by the intramuscular as by the oral route.

A monoclonal antibody to the interleukin-2 receptor enhances the survival of neural allografts: a time-course study

A time-course study of the survival and immunological characteristics of rat neural allografts was undertaken in animals treated with a murine monoclonal antibody to the alpha-chain (p55) of the rat interleukin-2 receptor. This antibody, NDS 63, was administered for ten days following grafting beginning on the day of operation. Inbred rat strains differing at both major and minor histocompatibility loci were selected as donor and host. Furthermore, the recipient strain displayed a high responder major histocompatibility complex haplotype. All grafts were placed in the lateral ventricle. Comparison was drawn between NDS 63-treated recipients and two groups of controls; an untreated group and a second group treated with the monoclonal antibody NDS 66, directed at a second epitope on the alpha-chain of the interleukin-2 receptor, which has been shown to be ineffective in competing with interleukin-2 for binding. Immunocytochemical analysis of the transplants was performed at several time-points up to 150 days following grafting. Grafts of NDS 63-treated recipients exhibited 100% survival with minimal induction of major histocompatibility complex antigens (both class I and class II) and negligible leukocyte infiltration at all time-points studied. In contrast grafts from both groups of controls showed evidence of a chronic immune response with most grafts undergoing rejection as shown by markedly elevated major histocompatibility complex antigen expression accompanied by specific immune cell infiltration. This was a protracted process with several grafts undergoing complete rejection by 60 days and a majority, but not all, by 150 days after transplantation. It is concluded that NDS 63, a monoclonal antibody to the interleukin-2 receptor, may diminish the immune response to transplanted allogeneic neural tissue and thereby enhance its prospects for long-term survival.

Fertilization failure of frozen mouse oocytes is not due to premature cortical granule release

The proportion of mouse oocytes that were fertilized in vitro after storage at -196 degrees C in the presence of 1.5 M dimethylsulfoxide (DMSO) was significantly lower than in unfrozen controls (39% vs. 81%). Sperm failed to penetrate the zona pellucida of approximately 80% of the frozen oocytes that remained unfertilized. Removal of the zona restored fertilization to control levels, indicating that changes induced in the zona during freezing and/or thawing were the primary cause of fertilization failure. Sperm-oocyte fusion, sperm nucleus decondensation, and the resumption of meiosis in frozen oocytes appeared to be delayed but subsequently fertilization progressed normally. No evidence was found to suggest zona modification by the premature release of fucosyl-rich glycoconjugates of cortical granule origin onto the surface of the plasma membrane of frozen oocytes stained immediately after thawing with fluorescently labeled Ulex europaeus lectin. Only a few frozen (less than 5%) and control (less than 3%) oocytes that failed to fertilize in vitro had fucosylated molecules on the plasma membrane. Prolonged exposure of fertilized oocytes to DMSO at 4 degrees C did not alter the pattern of lectin binding. In conclusion, fertilization is inhibited in frozen-thawed oocytes by as yet undefined modifications to the zona pellucida which do not involve the premature release of cortical granules.

Effect of slow and ultra-rapid freezing on cell surface antigens of 8-cell mouse embryos

The distribution of four cell surface antigens (SSEA-1, SSEA-3, SSEA-4, and I) present on mouse preimplantation embryos was examined on 8-cell stage embryos immediately after flushing from the reproductive tract and after slow or ultra-rapid freezing. Frozen-thawed and nonfrozen embryos were also examined after culture in vitro for 5, 24, or 48 h. Immediately after thawing, embryos showed a disruption in the polarity of cell surface antigens SSEA-3, SSEA-4, and I, but no differences were detected in fluorescence intensity or various other staining characteristics. No long-term changes in the distribution of cell surface components were detected. Implantation and embryonic development were similar for frozen and nonfrozen embryos transferred to the uterine horns of pseudopregnant recipients.

Effect of gonadotrophin environment on growth and development of isolated mouse primary ovarian follicles

Collagen gels containing isolated primary follicles devoid of other ovarian tissue were transferred beneath the kidney capsule of 3 types of female recipients: cycling, ovariectomized and hypogonadal, known to have different circulating concentrations of gonadotrophins. After 10 days the gels were recovered and processed for histology or the oocytes were recovered and their diameters measured and their ability to resume meiosis was determined. The growth of isolated primary follicles was positively correlated with the concentrations of circulating gonadotrophins in the recipient mice, but the numbers of oocytes recovered, the rate of oocyte growth and resumption of meiosis did not differ in the 3 types of recipient studied. This indicates that, in the conditions provided, oocyte growth was not related to the extent of follicular development.

The tolerance and toxicity of clarithromycin

In a programme of Phase II and III trials, 3437 patients received clarithromycin. Twenty percent of these patients reported adverse events, and three-quarters of these were thought to be possibly or probably linked with the drug. Only 1% of these were severe and most of the adverse events (11% of patients) were digestive system upsets. There was no significant relationship between the dosage of clarithromycin and the incidence of adverse events. Comparison between clarithromycin and the other antibiotics used in controlled trials showed similar side effects reported for beta-lactam agents and clarithromycin but adverse events were reported less frequently with clarithromycin (19%) than with erythromycin (29%) and other macrolides. This was particularly noticeable for adverse events of the digestive system (9% with clarithromycin vs 20% with erythromycin). No significant haematological, hepatic or renal toxicity due to clarithromycin was reported. There may be slight elevation of theophylline levels during concomitant clarithromycin administration.

The immune response to intracerebral neural grafts

Neural transplantation offers a potential therapeutic approach to a variety of neurological disorders, most notably those of a degenerative nature. However, the degree of immunological privilege (i.e. isolation from an immune response) in the brain, which is not absolute, may be a significant impediment to the survival of histoincompatible grafts. The nature of this privilege, together with the specific immune events leading to neural graft rejection, are discussed. As a consequence of this immune-mediated rejection, immunosuppression in some form might be necessary to guarantee long-term graft survival. Various strategies are being explored to suppress the immune response to neural grafts, not only for future use in clinical therapies, but also to bring intracerebral allo- and xenotransplantation to the attention of the general neurobiologist.

The clinical presentation and diagnosis of invasive fungal infections

The frequency of invasive fungal infections is increasing owing to the increasing numbers and improved survival of immuno-compromised patients. The fungi responsible for these infections are predominantly opportunistic pathogens. The clinical features and diagnosis of the four commonest infections (invasive candidosis and aspergillosis, cryptococcosis and mucormycosis) are discussed. Particular emphasis is given to the identification of risk factors for these infections, which are different for each disease. As these organisms are common contaminants or commensals, definitive diagnosis requires culture from sites that are normally sterile or histological demonstration of tissue invasion. Definitive diagnosis is not always possible, in part owing to the severe nature of patients' underlying illnesses. A high proportion of cases are diagnosed post mortem because of difficulties in establishing a diagnosis. Clinical diagnoses thus need to be made early in the course of these infections, but a high index of suspicion and knowledge of the clinical manifestations are required.

Effect of dibutyryl cyclic adenosine monophosphate on granulosa cell proliferation, oocyte growth and meiotic maturation in isolated mouse primary ovarian follicles cultured in collagen gels

Isolated primary follicles from 10-day-old mice were cultured in a collagen gel matrix for 6 days in Minimum Essential Medium + foetal calf serum, followed by culture in unsupplemented medium (control) or in medium containing hypoxanthine (2 mM) or dibutyryl cyclic adenosine monophosphate (dbcAMP, 0.25 mM) for a further 3 or 6 days. Less than 10% of oocytes resumed meiosis during the culture period in all groups. At recovery, the diameter of oocytes at the germinal vesicle stage was recorded and their ability to resume meiosis was determined. Hypoxanthine had little effect on oocyte growth and meiotic competence, but culture in dbcAMP resulted in oocytes that were larger (60.2 +/- 0.6 microns) than those of controls (55.8 +/- 0.5 microns) and more competent to resume meiosis than were controls (42.9% and 10.8%, respectively). The addition of dbcAMP to the culture medium induced a 4-5-fold increase in the number of granulosa cells oocyte compared with controls (3757 +/- 423 and 838 +/- 93, respectively). These results indicate that increased oocyte growth and meiotic competence is primarily mediated via dbcAMP effects on the granulosa cells.

Neutron and x-ray scatter studies of the histone octamer and amino and carboxyl domain trimmed octamers

The structure of the nucleosome has been under intense investigation using neutron crystallography, x-ray crystallography, and neutron solution scattering. However the dimension of the histone octamer inside the nucleosome is still a subject of controversy. The radius of gyration (Rg) of the octamer obtained from solution neutron scattering of core particles at 63% 2H2O, 37% 1H2O is 33 A, and x-ray crystallography study of isolated histone octamer gives a Rg of 32.5 A, while the reported values using x-ray crystallography of core particles from two individual studies are 29.7 and 30.4 A, respectively. We report here studies of isolated histone octamer and trypsin-limited digested octamer using both neutron solution scattering and small angle x-ray scattering. The Rg of the octamer obtained is 33 A, whereas that of the trimmed octamer is 29.8 A, similar to the structure obtained from the crystals of the core particles. The N-terminal domains of the core histones in the octamer have been shown by high resolution nuclear magnetic resonance (Schroth, G.P., Yau, P., Imai, B.S., Gatewood, J.M., and Bradbury, E.M. (1990) FEBS Lett. 268, 117-120) to be mobile and flexible; it is likely that these regions are disordered and "not seen" by x-ray crystallography.

Effects of ginger on motion sickness susceptibility and gastric function

This study was designed to evaluate the antimotion sickness activity of ginger root (Zingiber officinale) and to characterize the effects of ginger on gastric function. Twenty-eight human volunteers participated in the project. Subjects made timed head movements in a rotating chair until they reached an endpoint of motion sickness short of vomiting (malaise III or M-III). Each subject was tested with either ginger or scopolamine and a placebo. A substance was judged to possess antimotion sickness activity if it allowed a greater number of head movements compared to placebo control. Gastric emptying of a liquid was measured by nuclear medicine techniques in normal and motion sick subjects. Gastric electrical activity was monitored by cutaneous (surface) electrodes positioned over the abdominal area. Powder ginger (whole root, 500 or 1,000 mg) or fresh ginger root (1,000 mg) provided no protection against motion sickness. In contrast, subjects performed an average of 147.5 more head movements (p less than 0.01) after scopolamine (0.6 mg p.o.) than after placebo. The rate of gastric emptying was significantly (p less than 0.05) slowed when tested immediately after M-III but was inhibited less when tested 15 min after M-III. Powdered ginger (500 mg) had no effect on gastric emptying in normal or motion-sick subjects. Gastric motility was also changed during motion sickness. The frequency of the electrogastrogram (EGG) was increased after M-III (tachygastria) and the normal increase in EGG amplitude after liquid ingestion was reduced in motion sick subjects. Although powdered ginger (500 mg) partially inhibited tachygastria in motion sickness, it did not enhance the EGG amplitude in motion sick subjects. We conclude that ginger does not possess antimotion sickness activity, nor does it significantly alter gastric function during motion sickness.

Growth in vitro and acquisition of meiotic competence after the cryopreservation of isolated mouse primary ovarian follicles

The growth and acquisition of meiotic competence of oocytes from fresh and frozen-thawed primary follicles collected from 10-day-old mice was compared during culture in collagen gels for 12 days. The oocytes contained in primary follicles have a mean diameter of about 48 microns and do not resume meiosis without further growth and development. During the 12-day culture period the mean diameter of the oocytes increased to over 60 microns. The oocytes were capable of resuming meiosis when isolated from the gel and cultured in the absence of follicular cells in a manner similar to that observed in vivo. Freezing and thawing did not affect oocyte growth or the ability to resume meiosis; this demonstrates the possibility of storing large numbers of female gametes for subsequent development.

Treatment of typhoid fever and infectious diarrhoea with ciprofloxacin

Ciprofloxacin and other related fluorinated 4-quinolones have microbiological and pharmacokinetic properties that suggest they could be useful agents in the management of typhoid fever and bacterial gastroenteritis. Initial studies confirm that this is the case. Against fully sensitive Salmonella typhi ciprofloxacin is clinically as effective as chloramphenicol or co-trimoxazole. It is also effective treatment for antibiotic-resistant strains which cause epidemic and endemic infection throughout the world. Furthermore, ciprofloxacin appears to eliminate chronic carriage of Salm. typhi more efficiently than other antibiotics. Ciprofloxacin has excellent in-vitro activity against all the bacterial pathogens that commonly cause infective diarrhoea. There are limited data concerning its use in the treatment of shigella dysentery but, in appropriate situations, ciprofloxacin is effective treatment for salmonella enteritis and is also effective in infections complicated by septicaemia and bone and liver abscesses. Ciprofloxacin appears to be of benefit in Campylobacter jejuni enteritis and is effective in the treatment of travellers' diarrhoea were enterotoxigenic Escherichia coli and shigellae are most important.

Genome cryopreservation: a valuable contribution to mammalian genetic research

Mouse embryo banking has become an important asset to geneticists. Individual laboratories can now maintain a far greater diversity of stocks than by conventional breeding alone. Also, many mutations that in the past would have been discarded due to lack of space, can now be preserved for future use. Recent advances in cryopreservation techniques have simplified procedures and, in certain cases, resulted in increased rates of survival.

Hip pain in late pregnancy

Hip pain in late pregnancy is quite common, and its etiology is rarely established unless acute demineralization occurs. We measured the bone mineral content of both hips in 26 women within 48 hours of delivery. Twelve of 36 densities (33%) were decreased in a group with severe pain when compared to 12 of 120 decreased densities (10%) in the remaining patients (P less than .05). Those data suggest that severe hip pain may be related to a decrease in bone mineral content.

Mechanisms and clinical significance of resistance to new beta-lactam antibiotics

The newer beta-lactam antibiotics, including various ureidopenicillins, second- and third-generation cephalosporins, carbapenems and monobactams, are active against many bacteria that are resistant to older penicillins, such as ampicillin and ticarcillin. Nonetheless, resistance to the newer agents can arise, and in this article the mechanisms whereby it does so are reviewed and their clinical significance is discussed.

Extra-ovarian production of mature viable mouse oocytes from frozen primary follicles

Isolated primary mouse follicles can be frozen successfully and thawed in the presence of 1.5 m-DMSO. Similar proportions of freshly collected and frozen-thawed primary follicles undergo folliculogenesis in the absence of other ovarian tissue. Some of the mature oocytes recovered from these follicles were fertilized in vitro and, after transfer to pseudopregnant recipients at the 2-cell stage, developed into live young. Cryopreservation and extra-ovarian development of immature follicles provide a unique opportunity to store large numbers of female gametes.

Photodegradation of doxorubicin, daunorubicin and epirubicin measured by high-performance liquid chromatography

The degradation kinetics of doxorubicin, daunorubicin and epirubicin in aqueous solution under fluorescent light and sunlight were studied using high-performance liquid chromatographic (HPLC) methods. The rates of photodegradation of all three drugs were similar, they were inversely proportional to the drug concentration and were accelerated by an increase in the pH of the vehicle. Photodegradation followed first-order kinetics. At concentrations greater than or equal to 500 micrograms/ml no special precautions appeared to be necessary to protect freshly prepared solutions of these agents from light. Photolysis was very rapid, however, at concentrations in the low microgram range therefore, when these solutions are used for in-vitro work or stability studies, they should be protected from light at all times. In addition, adsorptive losses, which may also be pronounced in low concentration solutions, should be prevented by storage in polypropylene containers.

Stability of doxorubicin, daunorubicin and epirubicin in plastic syringes and minibags

The shelf lives of doxorubicin, daunorubicin and epirubicin in infusion fluids were studied using high-performance liquid chromatographic (HPLC) methods. Doxorubicin and epirubicin were stable (loss in potency of less than 10%) for 24 and 20 days respectively, when dissolved in sodium chloride solution (0.9%; pH, 6.47) at 25 degrees C and stored in polyvinyl chloride (PVC) minibags, while daunorubicin was stable for at least 43 days. All three drugs were stable for at least 43 days in sodium chloride (0.9%; pH 6.47 and 5.20) and dextrose (5%; pH 4.36) at 4 and -20 degrees C. Repeated thawing and re-freezing of these solutions at ambient temperature did not cause degradation. All three drugs were stable for at least 43 days when reconstituted with Water-for-Injections BP and stored in polypropylene syringes at 4 degrees C.

Issues involved in combining drugs with psychotherapy for the borderline inpatient

The hospitalized psychiatric patient is commonly treated with both pharmacotherapy and psychotherapy. This is definitely true of borderline patients whose pathology is contributed to by both biologic and psychodynamic factors. For several reasons, it is particularly difficult to provide these patients the ideal conditions for both approaches within the same inpatient program. First, even the best assessment of a borderline patient may leave the clinical team uncertain as to what degree biologically based pathology plays a part. Second, the current state of research on borderline conditions leaves a clinician very unsure whether to use drugs, what drugs to use, and what form of psychotherapy would be most useful. These two basic sets of uncertainty provide fertile soil for polarization, reductionism, and fuzzy eclecticism. Third, the borderline patient's clinical condition can change rapidly and unpredictably, especially in response to new interventions. The pathology can therefore change before the clinician's eyes. It can be difficult to know whether the dramatic responses reflect efficacy or manifestations of primitive transference reactions. Fourth, the staff members working with the borderline patient commonly have strong emotional reactions, often unconscious ones. The urges to hold, love, rescue, attack and destroy, or the desire to keep a distance can easily influence decisions about whether to prescribe a drug or whether to change the nature of the psychotherapy. These third and fourth factors make it very difficult, once treatments are underway, to evaluate efficacy objectively and to stay the steady course that borderline patients often need above all. Fifth, the case illustration nicely demonstrates that arguments in a team based on philosophical differences, diagnostic disagreements, and fueled by the splitting maneuvers of borderline patients can lead to intrastaff devaluation and mistrust. A number of recommendations have been offered to help with the management of combined inpatient drug-psychotherapy treatment.

Therapy: the clinician's view

The therapy of septicaemia often has to be started empirically and the clinician's choice of antibiotic depends upon awareness of data collected by the microbiologist concerning the species and sensitivity of the likely infecting bacteria. There is, however, no unequivocally correct choice and host factors, previous antibiotic use and local formulary recommendations need to be considered. The role of new antibiotics, the potential for cidal agents to be detrimental, the use of antibiotic combinations, the dose and duration of therapy are also still debatable. Even with optimal antibiotic therapy, some patients with septicaemia still die. Several forms of adjunctive therapy have been shown to be unhelpful but developments in immunotherapy hold out some promise.

Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness

In addition to nausea and vomiting, motion sickness involves slowing of brain waves, loss of performance, inhibition of gastric motility and the Sopite Syndrome. The therapeutic effects of antimotion sickness drugs on these reactions were evaluated. The subjects were rotated to the M-III end-point of motion sickness. Intramuscular (IM) medications were then administered. Side effects before and after rotation were reported on the Cornell Medical Index. Brain waves were recorded on a Grass Model 6 Electroencephalograph (EEG), and gastric emptying was studied after an oral dose of 1 mCi Technetium 99m DTPA in 10 oz. isotonic saline. An increase in dizziness and drowsiness was reported with placebo after rotation. This was not prevented by IM scopolamine 0.1 mg or ephedrine 25 mg. EEG recordings indicated a slowing of alpha waves with some thea and delta waves from the frontal areas after rotation. IM ephedrine and dimenhydrinate counteracted the slowing while 0.3 mg scopolamine had an additive effect. Alterations of performance on the pursuit meter correlated with the brain wave changes. Gastric emptying was restored by IM metoclopramide. Ephedrine IM but not scopolamine is effective for some of the secondary effects of motion sickness after it is established.

Desmoglein II-derived glycopeptides in human epidermis

Antisera raised against a major 78 kD glycopeptide from pig epidermis were used to identify desmoglein II-derived glycopeptides in the conA-binding material isolated from human epidermis. In whole CaCl2-separated epidermis the antiserum recognized conA-binding components with apparent Mr of 115, 100, 82, 68, 50, 48, and 46 kD. The 82, 68, 48, and 46 kD immunoreactive bands were present in normal stratum corneum and plantar callus. Psoriatic scales contained significantly more of the 82 kD components and less of the 48 and 46 kD bands. Psoriatic scales also contained a major 50 kD conA-binding component unrelated to keratins or desmoglein II. Proteolytic peptide mapping showed that the major immunoreactive bands in normal stratum corneum and plantar callus were also chemically related. The 82 to 46 kD immunoreactive glycopeptides in plantar callus coincided with the major coomassie blue stained bands and were homogeneous on two-dimensional gels suggesting that this tissue may be a valuable source of human desmoglein II-derived glycopeptides. An antiserum directed against the electrophoretically co-purified 48/46 kD glycopeptides from plantar callus recognized the 82 to 46 kD bands in immunoblotting. In indirect immunofluorescence of frozen skin sections this antiserum stained the surface of epidermal cells in the spinous and granular layers of the tissue. In immunogold labeling of paraformaldehyde-fixed skin sections affinity-purified antibodies stained intact desmosomes in spinous and granular cells and desmosomal remnants in the stratum corneum. The results are consistent with our hypothesis that desmoglein II undergoes limited cleavage to stable fragments during terminal differentiation. Proteolytic degradation appears to be incomplete in psoriatic epidermis.

The short-term use of luteinising hormone-releasing hormone analogues in uterine fibroids

Twelve patients with uterine fibroids, who were due to undergo myomectomy, were treated preoperatively with the luteinising hormone-releasing hormone analogue, Zoladex. This resulted in a marked reduction in uterine and fibroid volume and surgery was facilitated.

Tissue penetration and clinical efficacy of enoxacin in respiratory tract infections

Enoxacin, in common with other new oral 4-quinolones, has a broad spectrum of antimicrobial activity which includes most pulmonary pathogens (with the exception of Streptococcus pneumoniae, against which its activity is poor); this spectrum has provided the impetus for investigation of its potential in the treatment of respiratory infections. Initial pharmacokinetic studies have demonstrated that the drug has a large volume of distribution and achieves concentrations in the secretions of the respiratory tract that are at least as high as those attained in the serum. These concentrations are sufficient to suggest that enoxacin would be effective treatment for most respiratory infections. Furthermore, the concentration of enoxacin that is achieved within the bronchopulmonary tissues is considerably higher than peak serum concentrations and suggests not only that there is an active transport mechanism, but also that the drug could be expected to eradicate organisms in the lungs such as streptococci that are considered moderately sensitive to the drug in vitro. There are relatively few clinical studies of, and thus limited data on, the efficacy of enoxacin in the treatment of respiratory tract infections. A review of the evidence suggests that enoxacin is as successful as other therapies used in the treatment of acute exacerbations of chronic bronchitis. There have sometimes been failures of eradication of, and occasional superinfections with, pneumococci. Enoxacin is also likely to interact with the metabolism of theophylline and so lead to elevated theophylline plasma concentrations. Hence when these 2 agents are given concurrently, careful monitoring of theophylline concentrations and/or dosage adjustments are recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy of oral acyclovir treatment of acute herpes zoster

Oral acyclovir, 800 mg five times per day for seven days, was compared with placebo in a randomized, double-blind trial conducted at three centers in the United Kingdom. The study group consisted of 364 elderly immunocompetent patients with herpes zoster who were entered within 72 hours of the onset of rash. Acyclovir significantly reduced the times to last new lesion formation (p less than 0.01), loss of vesicles (p less than 0.01), and full crusting (p = 0.03). No significant hastening of rash healing was seen in those who started therapy later than 48 hours after the onset of rash. There was also a significant reduction pain during treatment with acyclovir (p = 0.02). Acyclovir produced no effects on the frequency or severity of post-herpetic neuralgia. No clinically important adverse effects of acyclovir were reported.

The use of aztreonam in serious gram-negative infections

Aztreonam, the first available monobactam, was used to treat 38 episodes of serious infection presumed or proven to be due to aerobic Gram-negative bacteria. On 15 occasions it was used empirically in combination with other antibiotics and on 23 occasions as therapy specifically directed against Gram-negative pathogens. Thirty-six Gram-negative infections were documented (including 23 septicaemias) and 35 of them were clinically cured by aztreonam. Likewise 35 of the 36 aerobic Gram-negative pathogens were eradicated. Both of the failures (one clinical and one microbiological were Salmonella infections). No major toxicity was seen but there were five superinfections (four due to Streptococcus faecalis). The results indicate that aztreonam is a useful alternative to the aminoglycosides or the broad-spectrum beta-lactam antibiotics for the treatment of severe Gram-negative infections.

Teicoplanin in the treatment of skin and soft tissue infections

Twenty-five patients with cellulitis or other soft tissue infections were treated with once daily teicoplanin. One patient was withdrawn from the study because of a protocol violation but 27 of the 29 assessable infections in the other 24 patients were clinically cured or improved. Eighteen of the 20 original Gram-positive bacterial isolates (11 Staphylococcus aureus and nine beta-haemolytic streptococcus strains) were completely eradicated. No severe adverse reactions were seen but a rise in the plasma platelet count was noted in the majority of the patients during teicoplanin administration.

Nuclear medicine evaluation of motion sickness and medications on gastric emptying time

Diminished gastric motility and lack of bowel sounds have been observed in astronauts aboard the Space Shuttle (4). In this study subjects were given scopolamine 0.6 mg with d-amphetamine 5 mg with and without neostigmine 15 mg. Neostigmine 15 mg alone was also compared with placebo for effect on gastric emptying time. In an additional test, subjects performed head movements in a rotating chair to an end-point of motion sickness short of vomiting. Ten ounces of isotonic saline containing 1 mCl of Tc 99mDPTA was ingested 2 h after the medications and immediately after rotation. The counts from stomach contents were monitored with a Picker small field of view gamma camera every 30 s for 1 h. Gastric motility was inhibited by scopolamine and amphetamine with 14% residual count at the end of 1 h. When neostigmine was added to this combination the results were in the placebo range. Motion sickness produced a profound inhibition of gastric emptying with a 47% residual count. The results indicate that the gastric stasis encountered in space is due mainly to motion sickness with a minimal contribution from the antimotion sickness drugs.

Mechanisms of antimotion sickness drugs

Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end-point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg and amphetamine 10 mg.

RESULTS

Scopolamine increased tolerated head movements over placebo level by +81, scopolamine 1 mg + 183, d-amphetamine + 118, scopolamine 0.6/d-amphetamine + 165, and scopolamine 1 mg/d-amphetamine 10 mg + 201.

DISCUSSION

The drugs effective in preventing motion sickness are divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications.

CONCLUSIONS

The balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness.

Development of mouse embryos cryopreserved by vitrification

Eight-cell mouse embryos were cryopreserved by vitrification in a concentrated solution of dimethylsulphoxide, acetamide, propylene glycol and polyethylene glycol. This solution (designated VS1) does not crystallize when cooled to subzero temperatures but instead forms a glassy transparent solid. Embryos were exposed in three steps to a stock VS1 solution or a saline solution containing 90% of the cryoprotectants in the stock VS1 (90% VS1) and then the suspensions were vitrified by rapid cooling in liquid nitrogen. Of 568 embryos vitrified in 90% VS1, 80% developed in vitro and 98 normal fetuses or young (17% of the total) were produced after transfer to pseudopregnant recipients. By contrast, 22% of 153 embryos vitrified in the stock VS1 developed in vitro, but only one normal fetus was obtained after transfer. These results demonstrate that normal fetuses and young can be produced from embryos cryopreserved by the simple and rapid method of vitrification.