The expression of an N-CAM serum fragment is positively correlated with severity of negative features in type II schizophrenia

The expression of a 70-kD serum fragment of the neural cell adhesion molecule (N-CAM) in schizophrenia is described. Schizophrenic patients (n = 40) were found to have statistically significant increases (p less than 0.0001) in serum N-CAM levels when compared to normal individuals (n = 26), and this could not be associated with age or sex. This difference was more marked (p less than 0.0001) between type II schizophrenics (n = 13) and normal individuals (n = 26) than when patients in the overlap group between type I and type II schizophrenia (n = 18) were compared to normal individuals (p less than 0.001). This difference remained significant (p less than 0.01) when overlap patients were compared to those of type II schizophrenia. Furthermore, schizophrenic patients with lower serum N-CAM proved to be better responders to neuroleptic therapy. We suggest that these elevated serum N-CAM levels reflect an increased synaptic turnover rate in this psychotic state.

Delayed diagnosis of traumatic diaphragmatic hernia during pregnancy

We present a case of delay in diagnosis of diaphragmatic rupture and herniation in a pregnant 25-year-old woman. The diaphragmatic rupture was secondary to trauma sustained five months prior to presentation. Subsequent to her accident, she was provided medical care on multiple occasions for symptoms of intractable nausea, vomiting, and weight loss that were probably related to an expanding uterus and diaphragmatic herniation of abdominal contents. At the time she presented to us the herniation had progressed and she was experiencing severe respiratory difficulty. A nasogastric tube was placed for diagnosis and decompression. A chest radiograph provided the diagnosis of herniation of gastrointestinal contents through the left hemidiaphragm. A healthy 5-lb boy was delivered vaginally and subsequently a left thoracotomy was performed for decompression and repair of the diaphragm. The patient's hospital course after hernia repair was uneventful.

Emergency department daily record review: a quality assurance system in a teaching hospital

A system of daily patient chart review of 11 categories of physician documentation and patient care was implemented over a 36-month period at Allegheny General Hospital in Pittsburgh. A total of 108,317 charts of emergency patients were reviewed. Feedback on errors in all categories were given to the physicians responsible, and necessary corrective actions were taken as soon as possible. All new resident physicians rotated in two-month blocks and received orientation to patient care and chart documentation expectations prior to starting the service. All physicians' charts underwent the same thorough chart review. Not only did the percentage of errors decrease from the first months to the second months of the residents' rotations, but the yearly percentage of total errors decreased as the study progressed, from 5.47% to 3.57%.

Potassium

Potassium homeostasis is dependent on many physiologic and metabolic factors. Potassium level testing by the clinical laboratory can aid the emergency physician in planning treatment in suspected cases of potassium depletion or excess. Familiarization with indications for ordering tests of potassium level and correct interpretation of test results is essential for appropriate patient care.

Primary what?

What is meant by 'primary care' Is it peculiar to nursing? Is it concerned with Primary Health Care? The authors delivered this paper at one of the Special Interest sessions in Tel Aviv at the Quadrennial Congress and stimulated the audience to much thought. Are we sure we are always talking about the same thing?

Morphology and immunoelectron microscopy of AIDS virus

Lymphocytes infected with human T-lymphotropic virus type III/lymphadenopathy-associated virus were examined by thin-section and immunoelectron microscopy, with horseradish peroxidase as an electron-dense marker. There was no evidence of an intracytoplasmic virion precursor, but viral antigen accumulated at the plasma membrane. Particles formed at the plasma membrane, and most virus was found in extracellular spaces. Mature virus had an envelope with fuzzy surface projections surrounding a centric core and an electron-dense eccentric nucleoid.

Neuroleptic malignant syndrome

We present the case of a 35-year-old man who developed symptoms of the neuroleptic malignant syndrome (NMS) after taking prescribed, moderately high, therapeutic doses of haloperidol. When brought to the emergency department, he was comatose, hypotensive, and had rigid muscle tone and a core body temperature of 42.2 C. Although initial treatment was supportive, intubation, ventilator support, and further care in the intensive care unit were necessary. Ensuing disseminated intravascular coagulation was treated successfully and the patient was weaned from the ventilator on the third day after admission. He was discharged from the hospital 11 days after admission. Recently recognized drug therapy for NMS, such as bromocriptine mesylate and dantrolene sodium, was not used in this case.

Emergence of multidrug-resistant Mycobacterium fortuitum during treatment

We present a case of pulmonary infection with Mycobacterium fortuitum demonstrating the development of multidrug resistance during therapy with multiple drugs. Emergence of drug resistance in a previously sensitive M fortuitum has been described with single drug therapy, but never before with multiple drug treatment. Development of resistance in the setting of multiple drug therapy illustrates the importance of repeated susceptibility testing during therapy.

Metals in downtown Washington, DC gardens

Soil samples from 95 gardens and leaf vegetables from 33 gardens in an approximately 3 km(2) area of downtown Washington, DC were analyzed for Pb, Cd, Cu, and Zn. The mean soil Pb was 680 μg/g with a range of 40-5300 μg/g. Soil Pb values in this sample were considerably higher than those previously found for a sample of 70 gardens distributed throughout the city. In the downtown sample, 46% of the soil Pb values were above 500 μg/g and 17% were above 1000 μg/g. Soil Pb levels were found to be higher near the house than away from the house, a pattern that was also evident, though less pronounced, for Zn and Cd. Lead-based exterior paint was identified as the most likely source of soil Pb in several cases. The mean leaf vegetable Pb was 6.4 μg/g dry weight, a small but significant difference from the mean value of 4.5 μg/g obtained from the city-wide sample of 38 gardens.

Electron microscopic identification of rotavirus group antigen with gold-labelled monoclonal IgG

Colloidal gold was complexed with monoclonal IgG to the inner capsid of human rotavirus. The complex was then used as an immunoelectron microscopic marker to identify the location of the group-specific antigen of rotavirus.

Further observations on the ultrastructure of human rotavirus

The inner capsid layer of human rotavirus was found to preferentially break up into large ring-like morphological units. The outer capsid was found to be composed of capsomeres covered by a thin protein or glycoprotein covering. These capsomeres appeared to be broad headed and short stemmed, similar to the type of pin used to mark locations on a map (pushpin).

Excess second virial coefficients for some dilute binary gas mixtures

Excess and interaction second virial coefficients have been measured in the temperature range 290-320 K for 20 binary gaseous systems. Several of these systems have previously been studied by Brewer. The present values are in excellent agreement with his results. The excess virial coefficients have been used to calculate excess molar enthalpies of mixing at 300 K.

Antiviral activity of colostrum and serum immunoglobulins A and G

Enteric virus-specific IgA and IgG present in paired human sera and colostrums were measured by the enzyme-linked immunosorbent assay (ELISA). Virus-specific IgA was present in all colostrums, but virus-specific IgG could not be detected. The reverse was true when sera were assayed. Most of these colostrums also neutralized either polio virus or reovirus, as did IgA, which was separated from a pool of colostrums by exclusion chromatography. No correlation could be made between levels of neutralizing and ELISA antibody titers in colostrums.

Vapour pressures and excess Gibbs free energies of cyclohexane + n-hexane, + n-heptane and + n-octane at 298. 150 K

By means of a continuous dilution vapour pressure apparatus the excess Gibbs free energies of binary liquid mixtures of cyclohexane with n- hexane, n-heptane and n-octane at 298.150 K have been determined. The values of this excess function were positive at all concentrations and decreased with an increase in the chain length of the n-alkane. The maximum values, 75.9, 49.7 and 24.6 J mol-1, for the respective systems occurred in mixtures with a mole fraction of cyclohexane greater than 0.5.

Excess volumes for binary mixtures of n-alkanes + cyclohexane at 298.150 K by continuous dilution dilatometry

The excess volumes of binary mixtures of n-pentane, n-hexane, n- heptane, n-octane, n-nonane and n-decane+cyclohexane were measured at 298.150 K with a continuous dilution dilatometer. The excess volumes were positive with the exception of mixtures of n-pentane with cyclohexane for which values were negative at all concentrations. The results have been compared with those published recently from data obtained in three systematic studies involving pycnometry, a vibrating tube densimeter and a semi-continuous dilatometer.

Gastroenteritis due to rotavirus in an isolated Pacific island group: an epidemic of 3,439 cases

In the spring of 1964, 3,439 cases of acute gastroenteritis were reported from Truk District, an island group in the mid-Pacific. The causative agent was not identified in laboratory studies performed in that year. Retrospective serologic studies 15 years later with the complement fixation test and the enzyme-linked immunosorbent assay provided serologic evidence that this outbreak was caused by the human rotavirus that was first isolated in 1973.

Biophysical properties of a non-cultivable 29-nm enteric virus

A 29 nm non-cultivable virus (NCV) was detected in faecal extracts from children hospitalized for gastroenteritis. The NCV had a density of 1.35 g/ml in glycerol-potassium tartrate density gradients and was resistant to degradation by proteolytic enzymes, non-ionic detergents and pH extremes. The surface of these virus particles had knob-like projections which appeared to have a symmetrical arrangement. When heated to 56 degrees C, the virus was completely degraded to soluble components which could not be seen by electron microscopy.

Comparison of hemagglutination-inhibition, complement-fixation and enzyme-linked immunosorbent assay for quantitation of human rotavirus antibodies

The hemagglutination-inhibition test for detecting rotavirus antibody was evaluated by using simian rotavirus SA-11 as hemagglutinating antigen. Results show that the test is as sensitive as either complement fixation or the enzyme-linked immunosorbent assay for detecting antibody to rotavirus in human sera.

Lack of characteristic hexagonal surface structure on a newly isolated influenza C virus

The hexagonal surface structure believed to be characteristic for influenza C virus was not initially observed for a newly isolated virus of this type. After a few additional egg passages of the virus, however, the hexagonal structure could be readily seen on many virions.

Biochemical characterization of infantile gastroenteritis virus (IGV)

Enzymic and biophysical studies with purified infantile gastroenteritis virus (IGV) nucleic acid indicated that the virion contained a double-stranded RNA genome of approx. 14 x 10(6) daltons which could be separated by gel electrophoresis into eight bands of RNA which were comprised of 15 RNA species. Two major virus proteins, VP2 (mol. wt. = 135,000) and VP8 (mol. wt. = 40,000), which composed about 85% of the total virion protein, were detected in IGV particles by polyacrylamide gel electrophoresis. Eight additional minor proteins were also resolved.

Ultrastucture of the surface of Rickettsia prowazeki and Rickettsia akari

Negative-contrast electron microscopy revealed that the outer layer of the envelope of rickettsiae is composed of a matrix of tetragonally arranged subunits. The layer projects approximately 7 nm from the cell wall. It is suggested that this outer layer is analogous to the structure considered capsule-like in morphology.

Origin and structure of the group-specific, complement-fixing antigen of Rickettsia rickettsii

Rickettsia rickettsii was treated with ether and examined by negative-contrast electron microscopy. Group-specific complement-fixing antigen was seen to be originating from the cell wall. The antigen was composed predominately of round particles 10 to 60 nm in diameter. Intact R. rickettsii and antigen from ether-treated organisms were purified by density gradient centrifugation and analyzed by polyacrylamide gel electrophoresis. The whole rickettsial cell was composed of a minimum of 30 proteins which ranged in molecular weight from about 23,000 to 155,000. The "soluble" antigen contained nine proteins ranging in molecular weight from about 28,000 to 150,000.

Complement-fixing antigens produced by varicella-zoster virus in tissue culture

The complement-fixing antigens present in tissue cultures infected with varicella-zoster virus were separated into four components. There were (i) a cell-free soluble antigen, (ii) a cell-associated soluble antigen, (iii) a cell membrane-associated antigen, and (iv) a virion antigen. All four antigens were reactive with sera from patients with varicella or zoster, and about 90% of the total complement-fixing activity was found to be nonvirion associated.

Complement-fixing antigens of herpes simplex virus types 1 and 2: reactivity of capsid, envelope, and soluble antigens

Capsid, envelope, and nonvirion-associated soluble components of type 1 and type 2 herpes simplex virus (HSV) were obtained from infected monolayer cell cultures and used as complement fixation (CF) antigens. Capsids were prepared by treatment of cells with the nonionic detergent Nonidet-P40, envelope material by treatment of virions with ether and high pH, and soluble components were obtained from culture fluids of untreated cells. Serological studies with experimental anti-herpesvirus sera indicate that these serotypes share cross-reacting envelope, capsid, and soluble antigens with each other and with herpesvirus B but not with varicella virus. In addition, animals immunized with crude HSV preparations contain high levels of CF antibody (1:32 to 1:64) to soluble antigens, whereas sera from humans who have experienced natural infection contain low levels of antibody (</=1:8) to this antigen. Further testing with reference, capsid, and envelope antigens indicates that antibody levels to reference and capsid antigens are about the same in sera from healthy humans, whereas antibody to the envelope is decidedly lower in these sera. Herpes convalescent-phase sera contain higher levels of antibody to reference and envelope antigens than to capsid antigen.

Preparation of type 2 herpes simplex virus complement-fixing antigen

Comparable complement-fixing antigens of type 1 and type 2 herpes simplex virus were produced by extraction of infected African green monkey cells with 0.85% NaCl which was buffered at pH 9.0 with 0.05 m glycine-NaOH. The optimal antigen dilutions were higher in titrations against hyperimmune animal sera than in titrations against human sera. Complement-fixing antibody to type 2 herpes antigen was detected in 5 of 17 sera from healthy humans.

Nonspecific precipitation of serum proteins by sodium lauryl sulfate in agar diffusion and immunoelectrophoresis

The anionic detergent sodium lauryl sulfate (SLS), in a final concentration of 0.1% and greater, reacted with whole serum in agar diffusion and immunoelectrophoresis to form artifactual precipitin lines. These lines occurred when either Ionagar or agarose was used as the supporting gel and were not affected by the presence of urea and 2-mercaptoethanol. Analytic chemical tests confirmed that the precipitating agent is SLS, and staining techniques showed that the detergent precipitates both protein and lipoprotein components of whole serum. Multiple artifactual precipitin lines occurred with a wide variety of animal sera, and a single line formed with human 7S immunoglobulin. Hence, in agar diffusion studies in which SLS is present in the test system, these artifactual lines may be easily misinterpreted as true antigen-antibody precipitin reactions.