Haptoglobin typing in canine bloods

Haptoglobin typing by vertical electrophoresis in a discontinuous polyacrylamide gel was conducted on 47 dog blood samples, of which 19 were from Doberman pinschers, 20 from German shepherds, and 8 from pit bullterriers. Two phenotypes were common in the three breeds and could not be used to differentiate between them. Canine haptoglobin phenotypes were, however, sufficiently different from those of humans to warrant using haptoglobin typing as a method for determining the origin of bloodstains.

Anaesthesia and the child with HIV infection

The frequency of AIDS in the paediatric population is growing rapidly and is expected to get worse. The anaesthetist will participate in the care of these children in the operating room and the intensive care unit with increasing frequency and must therefore have an understanding of the many manifestations of this syndrome. Children become infected with HIV by transplacental transmission from mother to fetus in over 80% of cases. Early diagnosis in infants can be very difficult. Clinical manifestations of HIV infection in children result from damage to almost every organ system. Considerations for the anaesthetist include: the effects of medications, cardiovascular dysfunction, pulmonary disease, altered metabolism, equipment preparation, choice of anaesthetic, modes of viral transmission and psycho-social issues.

Unilateral superior rectus recession for the treatment of dissociated vertical deviation

The management of dissociated vertical deviation (DVD) is an unsettled issue. Several authors have advocated bilateral superior rectus recession for all patients with DVD unless a dense amblyopia is present in the nonfixating eye. Our experience suggested that DVD was being successfully treated with unilateral bilateral superior rectus recession. We reviewed the charts of 57 patients who underwent graded unilateral superior rectus recession and 10 patients who had bilateral superior rectus recession for the treatment of DVD. DVD, a manifest deviation, was considered as distinct from occlusion hyperphoria, a latent deviation present only under cover. Of the patients who underwent unilateral superior rectus recession, only six developed a significant (14 prism diopters or more) DVD in the unoperated eye. The presence of any DVD in the unoperated eye appeared to be predictive of an unacceptable postoperative deviation (15 times greater chance, P less than .001). Patients with an occlusion hyperphoria in the unoperated eye showed no increased propensity to develop a significant DVD following surgery. The results of bilateral surgery were disappointing. Eight of ten patients had residual DVD in one or both eyes of 10 delta or greater. Our results suggest that unilateral surgery is an effective treatment of DVD in patients with a manifest deviation in only one eye. Although neither unilateral nor bilateral surgery was entirely satisfactory for the treatment of bilateral DVD, we recommend bilateral superior rectus recession for these patients.

The persistence of neutralizing antibodies after revaccination against smallpox

Persistence of neutralizing antibodies after revaccination against smallpox was studied. Single serum samples from 140 revaccinated donors were tested for neutralizing antibodies using the plaque reduction assay. The donors, aged 21-49 years at sampling, had been vaccinated in infancy and revaccinated at 8 and 18 years; they formed seven groups of 20 men each, revaccinated about 3, 5, 10, 15, 20, 25, and 30 years before sampling. The differences in mean titer among groups were insignificant (P greater than .01). The titer significantly decreased during the first 3 years after the revaccination but remained stable for at least 30 years thereafter (geometric mean titer, 10.5; 95% confidence interval, 6.8-16.4). The results suggest that there is probably no need for routine revaccinations beyond the primary and two revaccinations; nevertheless, persons at high risk should be revaccinated regardless of their vaccination status.

Blood pressure, catecholamines, and pancreatic polypeptide in obstructive sleep apnea with and without nasal Continuous Positive Airway Pressure (nCPAP) treatment

In order to study blood pressure, adrenergic, and cholinergic activity in severe obstructive sleep apnea (OSA), 14 patients with apnea index (AI) greater than 30 apneas/h, mean apnea time index greater than 20 sec were studied before and with nasal Continuous Positive Airway Pressure (nCPAP). Sleep, respiration, arterial blood pressure, arterial plasma catecholamines [norepinephrine (NE) and epinephrine (E)], and plasma pancreatic polypeptide (PP) were measured without and after seven days treatment with nCPAP. Initially in the apnea, arterial blood pressure decreases, and thereafter steadily increases and shows a maximum during the first breath terminating the apnea. With nCPAP the arterial pressure variations disappeared. Awake morning systolic (SBP) and diastolic (DBP) blood pressure decreased the nCPAP treatment. A significant relation between the reduction in AI and the reduction in morning awake SBP and DBP with nCPAP treatment was observed. No significant changes in NE were observed with nCPAP treatment. Epinephrine decreased and PP increased significantly with nasal nCPAP treatment. The systolic and diastolic blood pressure reduction was significantly related to the decrease in E and the increase in PP. No association between sleep stages and plasma NE, E, and plasma-PP was found before treatment. With nCPAP treatment plasma-PP was higher during non-rapid eye movement (NREM) stage 2 to 4 sleep than during rapid eye movement (REM) sleep. Thus, morning awake arterial blood pressure and nocturnal arterial blood pressure decrease with nCPAP treatment in sleep apnea patients. These hemodynamic changes are related to the decrease in AI and sympathetic activity and the increase in parasympathetic activity.

Neuropeptide degradation by large vessel and microvessel-derived endothelial cells in vitro: cell surface catabolism of thyrotropin releasing hormone (TRH)

Cell surface ectopeptidase activity of purified, cultured large vessel and microvessel-derived endothelial cells (EC) was studied. Degradation of thyrotropin releasing hormone (TRH), and production of cyclo-His-Pro was significantly increased (P less than 0.001) in large vessel EC compared with microcapillary EC. Since the rate of catabolism in the microvascular capillary bed is 5 times less than that in the large vessel wall, peptide concentrations are likely maintained longer in close proximity to their site of biosynthesis, where they are presumably most active.

Infectious disease among Ethiopian immigrants in Israel

From 1980 to 1985, 14,465 refugees arrived in Israel from Ethiopia. Typhoid fever, tuberculosis, or malaria was present in 1.8% to 9% of immigrants; as many as 93% were infested with intestinal parasites. Extreme malnutrition was common, and serologic evidence of syphilis and hepatitis B was frequently encountered. A program for diagnosis, therapy, and immunoprophylaxis following the massive influx of African refugees is described.

Effect of ganglionic blockade on endogenous circulating pancreatic polypeptide, vasoactive intestinal polypeptide, substance P, neurotensin and noradrenaline in healthy controls and long-term insulin-dependent diabetic patients

Plasma pancreatic polypeptide (PP), vasoactive intestinal polypeptide (VIP), substance P (SP), neurotensin (NT) and noradrenaline (NA) were measured in eight healthy subjects and 12 long-term insulin-dependent diabetic patients with and without autonomic neuropathy, before and after intravenous infusion of the ganglionic blocking agent trimethaphan camsylate, in order to determine the influence of the autonomic nervous system on the baseline values of the substances. The basal levels of the measured substances were not significantly different in healthy subjects and patients with or without diabetic autonomic neuropathy. In healthy subjects, the ganglionic blockade induced a significant decrease in PP (80%) (P less than 0.02), NA (58%) (P less than 0.05), NT (27%) (P less than 0.05) and a significant increase in SP (30%) (P less than 0.05), while the VIP concentration remained unchanged. The diabetic patients had nearly the same significant decrease in PP (68%) (P less than 0.01), NA (50%) (P less than 0.01), NT (22%) (P less than 0.02), VIP (21%) (P less than 0.05) and increase in SP (73%) (P less than 0.01). No relationship was found between the autonomic neuropathy and changes of the substances during ganglionic blockade. The results indicate that the postganglionic part of the autonomic nervous system participates in the maintenance of a normal baseline level of PP, NT and NA, but not of VIP. The regulation of VIP may be disturbed in long-term diabetic subjects.

[Comparative studies on the rotavirus syndrome following infection with human rotavirus of the subgroup 1 or 2]

Human rotavirus infection which heals spontaneously causes gastroenteritis in newborns and infants. 150 pediatric patients infected with rotavirus as diagnosed by ELISA suffered from diarrhoea for an average of 3 days, from vomiting for 1 day, and/or fever for 1-2 days. Nowadays this disease is known as "human rotavirus syndrome". Human rotaviruses can be divided into at least 4 serotype antigens and some 3 further subgroup antigens. The serotype antigens are only detectable biologically (e.g. by neutralization test), whereas the subgroup antigens can be demonstrated as specific proteins by a solid-phase test (ELISA). This study investigated whether an infection with human rotavirus of subgroup 1 (21%) or 2 (77%), which occur most frequently causes different degrees of severity of the rotavirus syndrome. The clinical comparison of 27 (subgroup 1) and 98 (subgroup 2) infected patients shows that the disease is not significantly different. This means that the detection of subgroup antigens 1 and 2 does not result in a different prognosis for the disease. The diagnosis of subgroup antigens after human rotavirus infection is therefore clinically important only for the detection of nosocomial infections, especially due to the rarely occurring subgroups 1 and 3.

Metabolism of C-peptide in the dog. In vivo demonstration of the absence of hepatic extraction

The in vivo hepatic metabolism of connecting peptide (C-peptide) in relation to that of insulin has not been adequately characterized. A radioimmunoassay for dog C-peptide was therefore developed and its metabolism studied in conscious mongrel dogs, with sampling catheters chronically implanted in their portal and hepatic veins and femoral artery. The hepatic extraction of endogenous C-peptide under basal conditions was negligible (4.3 +/- 4.5%) and was similar to the hepatic extraction of C-peptide measured during the constant exogenous infusion of C-peptide isolated from dog pancreas. Simultaneously measured hepatic extraction of endogenous and exogenously infused insulin were 43.8 +/- 7.6 and 47.5 +/- 4.4%, respectively. The metabolic clearance rate of infused C-peptide was 11.5 +/- 0.8 ml/kg per min and was constant over the concentration range usually encountered under physiological conditions. In additional experiments, the effect of parenteral glucose administration on the hepatic extraction of C-peptide and insulin was investigated. The hepatic extraction of C-peptide (6.2 +/- 4.0%) was again negligible in comparison with that of insulin (46.7 +/- 3.4%). Parenteral glucose administration did not affect the hepatic extraction of either peptide irrespective of whether it was infused peripherally, intraportally, or together with an intraportal infusion of gastrointestinal inhibitory polypeptide. The fasting C-peptide insulin molar ratio in both the portal vein (1.2 +/- 0.1) and femoral artery (2.1 +/- 0.3) was also unaffected by the glucose stimulus. These results therefore indicate that, since the hepatic extraction of C-peptide is negligible and its clearance kinetics linear, the peripheral C-peptide concentration should accurately reflect the rate of insulin secretion. New approaches to the quantitation of hepatic extraction and secretion of insulin by noninvasive techniques are now feasible.

Gastroenteropancreatic hormonal changes during exercise

Peripheral plasma concentrations of gastroenteropancreatic peptides were measured during a 3-h period of bicycle exercise at 40% of maximal oxygen uptake in six normal men. Marked increases (P < 0.02) were found in vasoactive intestinal polypeptide (VIP) [1.8 +/- 0.7 (rest) vs. 22.3 +/- 5.4 pmol x l-1 (mean +/- SE) (3 h)], secretin (0.5 +/- 0.5 vs. 11.1 +/- 2.7 pmol x l-1), pancreatic polypeptide (PP) (4.0 +/- 1.5 vs. 46.3 +/- 11.5 pmol x l-1), somatostatin (SRIF) (12.8 +/- 1.2 vs. 17.7 +/- 0.6 pmol x l-1), whereas no changes occurred in gastric inhibitory polypeptide (37.3 +/- 5.9 vs. 39.2 +/- 9.8 pmol x l-1). Immunoreactive insulin and C-peptide decreased from 0.08 +/- 0.004 and 0.39 +/- 0.03 pmol x l-1, respectively, to 0.04 +/- 0.003 (P < 0.005) and 0.13 +/- 0.02 (P < 0.001). The significant decrease in C-peptide and in the C-peptide-to-insulin molar ratio indicate decreased insulin secretion and clearance, respectively, during exercise. Plasma glucose decreased [5.0 +/- 0.1 (rest) vs. 4.2 +/- 0.3 mmol.l-1 (3 h)] (P < 0.01). During 3 h of rest, none of the measured parameters had changed. The marked exercise-induced changes in plasma concentrations of PP, secretin, VIP, and SRIF are provocative. We know in detail neither the stimuli for the release of these peptides nor their physiological role during exercise.

Occurrence of human pancreatic polypeptide in pancreatic endocrine tumors. Possible implication in the watery diarrhea syndrome

Eighteen endocrine pancreatic tumors were examined for the occurrence of cells producing insulin, glucagon, gastrin, human pancreatic polypeptide (HPP), and vasoactive intestinal polypeptide (VIP) and for A1 cells. More than half of the tumors were mixed, i.e., they contained more than one type of hormone-producing cell. The clinical symptoms were attributable only to one of the hormones produced by the mixed tumors. Three of four tumors causing the watery diarrhea syndrome contained both VIP and HPP cells. In one such tumor there was a strong predominance of HPP cells; the serum HPP levels of this patient were a thousandfold elevated, whereas her VIP levels were within the normal range. Several lines of evidence point to HPP as a possible agent causing the watery diarrhea syndrome. In many of our patients, HPP cells hyperplasia was present in the extratumoral pancreas. Such hyperplasia may give rise to the raised serum HPP levels seen in many patients having endocrine pancreatic tumors.

The heterogeneity of gastrin, with reference to conversion of gastrin-17

High-resolution gel chromatography monitored by a sensitive radioimmunoassay for gastrin has disclosed that gastrin circulates in twenty different components. Since the assay is specific for the biological active sequence of gastrin (-Trp-Met-Asp-PheNH2), we conclude that all the twenty circulating molecular forms of gastrin encountered in this study may participate in the regulation of gastric acid secretion. There are two dominating forms of gastrin in serum: gastrin-34-like components and gastrin-17-like components. The former constituted 60% and the latter constitutes approximately 30% of the immunoreactive gastrins. We suggest that extragastrointestinal conversion of gastrin-17, released from tissue, is an important source of gastric-34-like components. Such conversion has been observed in intact man and pig. Studies with the isolated perfused porcine liver indicate that the liver is important in the metabolism of gastrin-17, and that conversion may be a hepatic function.

Imitative altruism by deaf children

The study was designed to investigate the influence of a behavioral model upon hearing-impaired children’s behavior and judgments. Children from a residential school for the deaf witnessed a model practice either charity or greed and preach charity, greed, or normatively neutral material.

A significant effect was obtained for the practices of the model; 30 of the 32 subjects imitated the behavior of the model to whom he had been exposed. Results are discussed regarding their implication for theories of altruistic behavior and remedial programs for the deaf.