Hydration of single-stranded phosphodiester and phosphorothioate oligodeoxyribonucleotides

Infrared spectroscopy was used to identify hydration-sensitive structural differences between single- stranded phosphorothioate (PS) and phosphodiester (PO) oligodeoxyribonucleotides. Spectra were recorded in the mid-infrared region, 500-1800 cm-1, at relative humidities between 0 and 98%; the PS and PO spectra are substantially different. The hydration effects on spectral bands in these single-stranded oligodeoxyribonucleotides is markedly different from such behavior in double- and triple-stranded oligodeoxyribonucleotides. A strong absorption occurs at 656 cm-1 in the phosphorothioate sample which is completely absent from the PO spectra. Gravimetric measurements were carried out on one PS and one PO sample to monitor and confirm hydration. The calculated BET adsorption constants [Brunauer, S., Emmett, RH. and Teller, E. (1938) J. Am. Chem. Soc., 60, 309-319] are 1.2 and 1.4 water molecules per nucleotide in the first hydration layer of PS and PO respectively. While the gravimetric data indicate that the single-stranded oligodeoxyribonucleotides hydrate very similarly to duplex DNA, the mid-infrared conformational marker bands are strikingly different from those observed for duplex DNA. In particular, the Vas of the phosphate group (PO2) at 1222 cm-1 in the single-stranded PO spectra is independent of relative humidity.

The rapid reversal of profound hypothermia using peritoneal dialysis

Severe hypothermia is associated with serious patient morbidity and mortality. The groups most frequently affected are the elderly, the very young and substance abusers. We describe three such cases which were successfully treated using warmed peritoneal dialysis. Two patients recovered completely and were left with no long term deficits. The third patient recovered from the acute event, but succumbed later to an underlying medical condition. Warmed peritoneal lavage is an efficient, cost effective approach which is easily performed without specialist equipment, and involves minimal risk to the patient.

Renal failure associated with alternative medical therapies

Because the kidney is the major excretory organ for drugs and toxins, it is especially susceptible to damage from such agents. While alternative medical therapies appear to be on an increase worldwide, there have been few case reports regarding their nephrotoxicity. However we have recently observed three patients who developed irreversible renal impairment, which we believe was due to such therapies.

Malignant and normal T cells show random use of T-cell receptor alpha chain variable regions in patients with cutaneous T-cell lymphoma

Cutaneous T-cell lymphoma (CTCL) is a malignancy of mature T lymphocytes, most of which express alpha/beta type T-cell receptors (TCRs). The cause of CTCL is unknown, but hypotheses postulating chronic stimulation of TCRs by superantigen or by a leukemogenic virus have been proposed. Either mechanism might produce bias in the TCR variable (V) region types used by the malignant cells. To determine if TCR alpha use is restricted in CTCL, we used reverse transcription and the polymerase chain reaction to determine V alpha and V beta usage by malignant cells purified from the peripheral blood of leukemic patients with CTCL. Usage of alpha chain V region segments appeared totally random; malignant lymphocytes isolated from each of six patients used different V alpha regions. As has been previously reported, no bias was found in beta chain V region usage either. In addition to productive (in frame) TCR V region mRNAs in malignant cells from each patient, we detected non-productive (out of frame) beta chain transcripts in these cells in two of six patients, and non-productive alpha chain transcripts in five of six. Residual normal peripheral blood lymphocytes from these patients showed a random, polyclonal or oligoclonal pattern of V region usage. We conclude that there is no bias in V region usage in CTCL, making it unlikely that interactions between superantigen or virus and the TCR V regions play a role in the pathogenesis of CTCL.

School nursing. Profile of five-year-olds in six primary schools

The health of 295 five-year-olds was screened by a school nurse at six primary schools in a socially deprived area of Wakefield, West Yorkshire, between September 1991 and August 1992. 64% of children were reported by their parents to have a medical condition, mainly asthma and other chest-related conditions (40%), ENT problems (32%) and eczema (19%). The poor health of children identified in this report highlighted the need to strengthen the school nursing service, and improvements are now under way.

Delayed postoperative paraplegia with hypotension in adult revision scoliosis surgery

The clear and reversible relationship of spinal cord function to postoperative hypotension is illustrated in a case of revision scoliosis surgery in an adult patient. The correlation of spinal cord monitoring by both magnetic cortical motor evoked potentials and spinal somatosensory evoked potentials to the clinical status is shown, and the importance of close postoperative observation of the adult revision case is emphasized.

Anterior mediastinal fibrosis with superior vena caval obstruction complicating the synovitis-acne-pustulosis-hyperostosis-osteomyelitis syndrome

A syndrome of predominantly palmo-plantar pustular psoriasis associated with anterior chest wall (sternoclavicular, manubriosternal) inflammation has previously been described. In this case, a further patient is reported where chest wall involvement is complicated by anterior mediastinal fibrosis and superior vena caval obstruction.

Temporal summation--the key to motor evoked potential spinal cord monitoring in humans

Spinal motor evoked potentials (SMEP) were recorded from tibialis anterior muscle after epidural stimulation of the spinal cord at the low cervical or high thoracic level during scoliosis surgery. By using a double stimulus pulse to produce temporal summation within the spinal cord a maximal CMAP response was readily achieved despite good surgical anaesthesia.

Stages of drug use acquisition among college students: implications for the prevention of drug abuse

The purpose of this study was to examine the stages of drug use acquisition among college students, and the relationship between stage status and motivation to avoid drugs and the frequency of drug use. Six hundred and sixty-nine students from a mid-size public university were selected to participate in the survey. College students were found to differ with regard to their stage of habit acquisition across five drugs. Stage status for a particular drug was associated with motivation to avoid that drug, with less motivation generally being related to greater stage advancement. Stage of acquisition for certain drugs was also found to be related to the frequency of use of other drugs, with alcohol and marijuana stage status being associated with the consumption of the greatest number of drugs. These results suggest that an acquisition stage heuristic holds promise in increasing our understanding of important developmental stages of drug use.

A classification for dry eyes following comparison of tear thinning time with Schirmer tear test

In a double-blind study a non-invasive method of examining the stability of the precorneal tear film was used to record tear thinning time on a population of 34 independently diagnosed dry eye patients. The results were compared with those for tear output, as inferred from the standard Schirmer tear test, and a correlation coefficient of 0.20 determined. The mean tear thinning time and Schirmer results for the population sample were 6.87 +/- 2.97 sec, and 5.62 +/- 5.69 mm wetting in 5 min, respectively. From a plot of tear thinning time against Schirmer a simple classification for dry eyes can be made. A Type A with normal tear stability and low output accounting for 14.70% of the dry eyes. A Type B with low tear stability and normal output, also accounting for 14.70% of the dry eyes. A Type C with low stability (less than 9.84 sec), and low output (less than 11.31 mm wetting in 5 min) accounting for 70.60% of the dry eyes.

Outbreak of adenoviral infections in a long-term paediatric facility, New Jersey, 1986/87

During an 8-week period in the winter of 1986-87, there were 11 deaths from an adenovirus infection (case fatality rate = 39%, 11/28) in a long-term care paediatric facility in southern New Jersey. Among the 61 resident children, all with severe congenital and/or acquired disabilities, 28 developed a febrile respiratory illness compatible with adenovirus infection [attack rate (AR) = 46%]. Patients with tracheostomies were three times as likely to become ill [relative risk (RR) = 3.2, 95% confidence intervals (CI) = 1.8-5.6]. Twenty-three members of the staff had a similar febrile illness (AR = 22%, 23/106); nurses were more likely to be ill than other staff (RR = 3.0, 95% CI = 1.1-11.4). Adenovirus 7 was isolated from four of the case patients and adenovirus 1 from one. The findings suggest prolonged transmission between patients and nursing staff with lack of cohorting of ill patients probably contributing to the prolongation of the outbreak. This investigation indicates that adenoviral outbreaks, although rare, can have a high mortality in severely disabled children, and that future outbreak investigations should examine the use of vaccines or antiviral agents to reduce mortality and for outbreak control.

Granulomatous orchitis. Review of 15 cases

Granulomatous orchitis is a rare lesion of the testis which can clinically simulate malignancy. The clinical, radiological and pathological features of 15 patients are presented and discussed.

An unusual case of adrenal cortical carcinoma

We describe a case of non-functioning adrenal cortical carcinoma, which recurred 16 years after surgical adrenalectomy. In addition, the patient was successfully treated for two anatomically separate and histologically different, primary malignant tumours. This case highlights the importance of lifelong follow-up after apparently curative surgical excision of an adrenal tumour.

A European and global strategy for a nursing information network

Information at every nurse researcher's fingertips. That is the goal of an information system for nursing services in Europe. Not only would it be able to provide fast information for analyzing and developing nursing but it also aspires to end the costly duplication of research work regionally and worldwide. Below, a report on how a European network can be developed to become a potential hub for a global nursing system.

Measurement of diffusing capacity in pulmonary embolism

Pulmonary function tests were carried out in 20 consecutive patients with pulmonary embolism (PE), diagnosed on the basis of a positive ventilation-perfusion lung scan carried out within 72 h of admission. Changes in forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and arterial blood gas tensions were too variable to be helpful diagnostically. In contrast, transfer factor (diffusing capacity) of the lung (TLCO) was significantly reduced in all cases and, in spite of a period of anticoagulation, tended to remain subnormal during a follow-up period of up to 3 years. Lung scans, however, tended to return to normal within 3 months of the incident. Thus, a reduction of TLCO to below 75% of the predicted normal was found in all cases with abnormal lung scans and such measurements provide a useful and simple screening test for PE; a normal TLCO would effectively exclude such a diagnosis. The failure of TLCO to return to normal in the majority of cases suggests persistence of the underlying physiological defect, in spite of normalization of symptoms and lung scans following anticoagulation.

Relation between precorneal tear film stability and tear production rate in normal eyes

The clinically diagnosed dry eye generally has an unstable tear film and changes in the corneal epithelium but, not necessarily, hyposecretion of tears. In normal asymptomatic eyes we found, using a noninvasive technique, a significant relation between precorneal tear film stability and tear production rates (TPR's).