An HPLC assay for sn-1,2-diacylglycerol

A method for the analysis of 1,2-diacylglycerols in biological samples is presented. After tissue extraction and derivatisation with 3,5-dinitrobenzoyl chloride, samples are analysed by normal phase HPLC, using a 3.9 x 300 mm microPorasil column, and ultraviolet detection at 254 nm. The method gives quantitative recovery of 1,2-diacylglycerol, and is of sufficient sensitivity to allow quantitation of 1,2-diacylglycerol in human muscle needle biopsy specimens, from as little as 10 mg muscle. Human skeletal muscle from fasted control subjects was found to have a 1,2-diacylglycerol content of 455 +/- 78 nmol/g wet weight. The method is robust, giving intra- and inter-assay coefficients of variation of 2.9% and 5.9%, respectively, and should prove useful for the analysis of 1,2-diacylglycerol levels in human disease states, such as diabetes, in which no measurements of 1,2-diacylglycerol have yet been undertaken.

Blistered: a gene required for vein/intervein formation in wings of Drosophila

We have characterized the blistered (bs) locus phenotypically, genetically and developmentally using a set of new bs alleles. Mutant defects range from wings with ectopic veins and intervein blisters to completely ballooned wings where the distinction between vein and intervein is lost. Mosaic analyses show that severe bs alleles behave largely autonomously; homozygous patches having vein-like properties. Developmental analyses were undertaken using light and electron microscopy of wild-type and bs wings as well as confocal microscopy of phalloidin- and laminin-stained preparations. bs defects were first seen early in the prepupal period with the failure of apposition of dorsal and ventral wing epithelia. Correspondingly, during definitive vein/intervein differentiation in the pupal period (18-36 hours after puparium formation), the extent of dorsal/ventral reapposition is reduced in bs wings. Regions of the wing that fail to become apposed differentiate properties of vein cells; i.e. become constricted apically and acquire a laminin-containing matrix basally. To further understand bs function, we examined genetic interactions between various bs alleles and mutants of two genes whose products have known functions in wing development. (i) rhomboid, a component of the EGF-R signalling pathway, is expressed in vein cells and is required for specification of vein cell fate. rhove mutations (lacking rhomboid in wings) suppress the excess vein formation and associated with bs. Conversely, rho expression in prepupal and pupal bs wings is expanded in the regions of increased vein formation. (ii) The integrin genes, inflated and myospheroid, are expressed in intervein cells and are required for adhesion between the dorsal and ventral wing surfaces. Loss of integrin function results in intervein blisters. Integrin mutants interact with bs mutants to increase the frequency of intervein blisters but do not typically enhance vein defects. Both developmental and genetic analyses suggest that the bs product is required during metamorphosis for the initiation of intervein development and the concomitant inhibition of vein development.

Redox control of beta-oxidation in rat liver mitochondria

Coupled rat liver mitochondria were incubated with [U-14C]hexadecanoate and carnitine which resulted in the formation of acyl-, 2-enoyl- and 3-hydroxyacyl-CoA and carnitine esters. The production of 2-enoyl-CoA and 3-hydroxyacyl-CoA esters was associated with a significant lowering of the NAD+/NADH ratio, in contrast to rat muscle mitochondria [Eaton, S., Bhuiyan, A. K. M. J., Kler, R. S., Turnbull, D. M. & Bartlett, K. (1993) Biochem. J. 289, 161-172], suggesting that control by the respiratory chain is important under normal conditions. When NAD+/NADH ratios were held low by succinate-induced reverse electron flow, 3-enoyl-CoA esters were also detected, probably formed by the action of 3,2-enoyl-CoA isomerase. Measurement of the flux of beta-oxidation at different osmolalities showed that flux was strongly dependent on osmolality changes in the physiological range. Measurement of the CoA and carnitine esters resulting from incubations made at different osmolalities showed that there was an increase in the amounts of the saturated acyl-CoA esters with respect to 2-enoyl-CoA and 3-hydroxyacyl-CoA esters, consistent with control by the electron-transfer flavoprotein-ubiquinone segment [Halestrap, A. P. & Dunlop, J. L. (1986) Biochem. J. 239, 559-565]. This however could not be the only factor operating as indicated by the continued presence of 2-enoyl-CoA and 3-hydroxyacyl-CoA esters at high osmolalities.

The primary self-assembly reaction of bacteriophage lambda cI repressor dimers is to octamer

Cooperative binding of the bacteriophage lambda cI repressor dimer to specific sites of the phage operators OR and OL controls the developmental state of the phage. It has long been believed that cooperativity is mediated by self-assembly of repressor dimers to form tetramers which can then bind simultaneously to adjacent operator sites. As a first step in defining the individual energy contributions to binding cooperativity, sedimentation equilibrium and steady-state fluorescence anisotropy methods have been used to study the higher order assembly reactions of the free repressor in solution. Wild-type repressor with 5-hydroxytryptophan (5-OHTrp) substituted for the native tryptophan [Ross et al. (1992) Proc. Natl. Acad. Sci. U.S.A. 89, 12023-12027] and two mutant repressor proteins that bind cooperatively to OR but have altered dimerization properties were also studied. We report here that the primary assembly mode of all four proteins is dimer to octamer. It is not dimer to tetramer as previously assumed. While tetramer does form as an assembly intermediate, dimer-octamer assembly is a concerted process so that tetramer is never a predominant species in solution. Sedimentation velocity experiments suggest that the octamer is highly asymmetric, consistent with an elongated shape. This conformation could allow octamers to bind simultaneously to all three operator sites at either OR or OL. Examination of tetramer and octamer concentrations suggests that both species could be involved in cooperative repressor-operator interactions. Our previous work used the unique spectral properties of 5-OHTrp to demonstrate that octamer binds single-operator DNA and is not dissociated to tetramer [Laue et al. (1993) Biochemistry 32, 2469-2472]. Taken together with the results presented here, octamers as well as tetramers must be considered in developing models to explain the cooperativity of lambda cI repressor binding to operator DNA.

External quality assessment in water microbiology: statistical analysis of performance

A UK-based scheme of water microbiology assessment requires participants to record counts of relevant organisms. Not every sample will contain the target number of organisms because of natural variation and therefore a range of results is acceptable. Results which are tail-end (i.e. at the extreme low or high end of this range) could occasionally be reported by any individual laboratory by chance. Several tail-end results might imply a laboratory problem. Statistical assessment is done in two stages. A non-parametric test of the distribution of tail-end counts amongst laboratories is performed (Cochran's Q) and, if they are not random, then observed and expected frequencies of tail-end counts are compared to identify participants who may have reported excessive numbers of low or high results. Analyses so far have shown that laboratories find high counts no more frequently than would be expected by chance, but that significant clusters of low counts can be detected among participants. These findings have been observed both in short-term and in long-term assessments, thus allowing detection of new episodes of poor performance and intermittent problems. The analysis relies on an objective definition of tail-end results. Working definitions are presented which should identify poor performance in terms of microbiological significance, and which allow fair comparison between membrane-filtration and multiple-tube techniques. Smaller differences between laboratories, which may be statistically significant, will not be detected. Different definitions of poor performance could be incorporated into future assessments.

5-hydroxytryptophan as a new intrinsic probe for investigating protein-DNA interactions by analytical ultracentrifugation. Study of the effect of DNA on self-assembly of the bacteriophage lambda cI repressor

Pairwise cooperativity between proteins bound to DNA is believed to be important in governing the transcriptional regulation of numerous genes. However, the spectral overlap of normal proteins and DNA has blocked the study of these interactions by many physical methods. As shown recently by Ross et al. (in press), lambda cI repressor spectrally enhanced by 5-hydroxytryptophan (5-OHTrp), expressed in vivo using an Escherichia coli tryptophan auxotroph, exhibits dimer formation and DNA binding properties identical with those of the wild-type repressor. Moreover, the 5-OHTrp provides a spectral signal that allows monitoring of the protein concentration without interference from DNA. In this article, the ability to selectively detect 5-OHTrp-labeled repressor during analytical ultracentrifugation is used to study the higher order assembly of repressor dimers in the absence and in the presence of operator DNA. Contrary to the expectation that tetramer might be the limiting oligomer, lambda cI repressor undergoes a definite association to octamer. The relatively narrow concentration range over which transition from predominantly dimer to predominantly octamer occurs makes it unlikely that significant levels of tetramer are formed in the absence of DNA. Moreover, mass measurements reveal that an OR1 oligonucleotide binds to octameric repressor and does not dissociate it to tetramers. The use of the 5-OHTrp spectral enhancement opens a promising new avenue for the exploration of protein-protein and protein-nucleic acid interactions by analytical ultracentrifugation.

The relationship between the St. Thomas and Oswestry disability scores and the severity of low back pain

OBJECTIVE

To investigate the relationship between the two disability questionnaires and low back pain severity using the visual analog scale (VAS).

DESIGN

One hundred sixty-two chiropractic patients with low back pain were interviewed using an interactive microcomputer system. The sources of data were the St. Thomas and Oswestry disability questionnaires for disability and a VAS for pain severity. All were inherent in the computer interview system.

SETTING

The computer review system was set up in the Anglo-European College of Chiropractic outpatient clinic.

PATIENTS, PARTICIPANTS

One hundred sixty-two consenting new patients from the general community suffering from low back pain who attended the Anglo-European College of Chiropractic outpatient clinic were asked to participate.

MAIN OUTCOME MEASURES

Main outcome measures were the St. Thomas and Oswestry disability questionnaires for disability and the VAS for low back pain severity.

RESULTS

There was a moderate correlation between the scores from the St. Thomas and Oswestry disability questionnaires (r = .77, p < .0001). A low but significant correlation score was found when comparing the St. Thomas and Oswestry disability score with pain severity (0.38, p < .0001, and 0.47, p < .0001, respectively).

CONCLUSION

The consequence of pain (disability) appears to have a weak relationship to pain severity. Despite the moderate correlation between the two disability questionnaires, it is suggested that they are not interchangeable.

Intramitochondrial control of the oxidation of hexadecanoate in skeletal muscle. A study of the acyl-CoA esters which accumulate during rat skeletal-muscle mitochondrial beta-oxidation of [U-14C]hexadecanoate and [U-14C]hexadecanoyl-carnitine

1. We describe the acyl-CoA and acyl-carnitine esters which arise from the incubation of well-coupled State 3 rat skeletal-muscle mitochondrial fractions with [U-14C]hexadecanoate and [U-14C]hexadecanoyl-carnitine. 2. Acyl-CoA ester intermediates of chain length 16, 14, 12, 10 and 8 carbons were detected. 3. Although incubations were in steady state in respect of oxygen consumption, 14CO2 production and generation of acid-soluble radioactivity, quantitative analysis of acyl-CoA esters showed that steady state was not achieved in respect of all intermediates. 4. 3-Hydroxyacyl- and 2-enoyl-CoA and -carnitine esters were found under normoxic conditions. 5. Direct measurement of NAD+ and NADH shows that under identical incubation conditions our observations cannot be explained by gross perturbation of the [NAD+]/[NADH] ratio. 6. We hypothesize that there is a small pool of rapidly recycling NAD+ channelled between complex I of the respiratory chain and the newly described mitochondrial-inner-membrane-associated beta-oxidation trifunctional enzyme [Uchida, Izai, Orii and Hashimoto (1992) J. Biol. Chem. 267, 1034-1041].

The Drosophila hedgehog gene is expressed specifically in posterior compartment cells and is a target of engrailed regulation

cDNAs were isolated that represent transcripts of the Drosophila segment polarity gene, hedgehog (hh). Sequence analysis reveals a motif characteristic of a transmembrane domain, suggesting that the hh protein is membrane-associated. hh expression in epidermal cells is confined to the posterior compartments and coincides precisely with that of engrailed (en). Despite the similar patterns of expression in the cellular blastoderm, hh expression is independent of en, but hh expression becomes sensitive to and dependent on en during the extended germ band stage. The ectopic expression of hh that is normally induced in patched (ptc) mutant embryos does not appear in ptc en double mutants. We discuss these findings in terms of the relationship between en and hh, and the role of the hh function.

Pharmacokinetic behavior of gadoteridol injection

RATIONALE AND OBJECTIVES

To assess the safety and pharmacokinetics of gadoteridol injection (0.5 M) in 18 healthy male volunteers in a phase I clinical trial.

METHODS

Volunteers were assigned to one of six dosing groups: 0.05, 0.1, 0.15, 0.2, 0.25, and 0.3 mmol/kg gadoteridol (0.5 M), in an ascending dose study. Physical examination, vital signs, electrocardiogram, clinical laboratory tests, and serum and urine samples were obtained at selected time points before and after administration of gadoteridol.

RESULTS AND CONCLUSIONS

No significant changes in vital signs, physical examination, clinical laboratory values, or electrocardiogram, that were believed by the principal investigator to be related to the administration of the contrast agent, were observed. A single adverse event (transient hive) believed to be related to contrast agent administration was observed in one volunteer. Pharmacokinetic data show that the elimination half-life and the distribution half-life were independent of the dose used. The mean distribution half-life was 0.20 +/- 0.04 hours, the mean elimination half-life was 1.57 +/- 0.08 hours, and greater than 94% of the drug was excreted in the urine in 24 hours.

Quantitation of acyl-CoA and acylcarnitine esters accumulated during abnormal mitochondrial fatty acid oxidation

We have used radio-high pressure liquid chromatography to study the acyl-CoA ester intermediates and the acylcarnitines formed during mitochondrial fatty acid oxidation. During oxidation of [U-14C]hexadecanoate by normal human fibroblast mitochondria, only the saturated acyl-CoA and acylcarnitine esters can be detected, supporting the concept that the acyl-CoA dehydrogenase step is rate-limiting in mitochondrial beta-oxidation. Incubations of fibroblast mitochondria from patients with defects of beta-oxidation show an entirely different profile of intermediates. Mitochondria from patients with defects in electron transfer flavoprotein and electron transfer flavoprotein:ubiquinone oxido-reductase are associated with slow flux through beta-oxidation and accumulation of long chain acyl-CoA and acylcarnitine esters. Increased amounts of saturated medium chain acyl-CoA and acylcarnitine esters are detected in the incubations of mitochondria with medium chain acyl-CoA dehydrogenase deficiency, whereas long chain 3-hydroxyacyl-CoA dehydrogenase deficiency is associated with accumulation of long chain 3-hydroxyacyl- and 2-enoyl-CoA and carnitine esters. These studies show that the control strength at the site of the defective enzyme has increased. Radio-high pressure liquid chromatography analysis of intermediates of mitochondrial fatty acid oxidation is an important new technique to study the control, organization and defects of the enzymes of beta-oxidation.

Novel protein-DNA interactions associated with increased immunoglobulin transcription in response to antigen plus interleukin-5

Although much has been learned about basal levels of immunoglobulin (Ig) transcription, the regulatory effects of cytokines and antigen (Ag) upon Ig expression in lymphocytes have not been fully characterized. We previously reported that Ag plus interleukin-5 (IL-5) caused increased steady-state Ig mRNA levels in Ag-specific cell lines. In this study, we have identified a region between -250 and -125 bp 5' of the Ig transcription start site that is necessary for the induction of increased mu mRNA levels by Ag plus IL-5. Mobility shift and UV cross-linking studies indicated that IL-5 plus Ag induced increased protein binding to this region. Furthermore, this sequence was found to be closely related to another A + T-rich sequence at -525 bp 5' of the transcription start site. Both sequences exhibited similar B-cell-specific and inducible protein binding. Our data suggest that treatment with IL-5 plus Ag induces several DNA-binding proteins, some of which may participate in increasing Ig transcription above basal levels by binding to sequences 5' of the octamer motif.

Assays for plasma complement activation by x-ray contrast media

Hemolytic complement activity and a C3a radioimmunoassay (RIA) were investigated for their ability to characterize contrast media (CM) with respect to complement activation. The CM tested were commercial formulations of diatrizoate, iodamide, iothalamate, ioxaglate, iohexol, and iopamidol. When plasma was exposed to CM, the hemolytic complement activity decreased and the C3a concentration increased. The C3a assay had a larger dynamic range and therefore more ability to discriminate among the CM. Using C3a data from pooled plasma or from individual donors' plasma, nonionic iopamidol (as Isovue 300) had lower complement-activating potential (P less than .005 and P greater than .05, respectively) than all of the ionic media based on diatrizoate, iothalamate, iodamide, and ioxaglate. The ranges of mean C3a values generated by saline, nonionic CM, and ionic CM were 48 to 60, 65 to 173, and 807 to 3272 ng C3a/50 microL, respectively. Complement activation was found to correlate with osmolality (r = 0.945, all media) and with molarity (r = 0.994, diatrizoates).

Repression of ci-D in posterior compartments of Drosophila by engrailed

A Drosophila strain was isolated that carries a lacZ-bearing recombinant P element integrated in the cubitus interruptus Dominant (ci-D) locus. This strain expresses beta-galactosidase in the anterior compartments of embryos and imaginal discs, suggesting that expression of ci-D is anterior-compartment specific. DNA from ci-D was cloned. In situ hybridization to imaginal discs confirmed that ci-D RNA is present only in anterior compartments. ci-D RNA is also limited to the anterior compartments at the germ-band extension stage of embryonic development, although not at earlier stages. In engrailed mutants, ci-D expression was derepressed in the posterior compartments of both embryos and imaginal discs. We postulate that engrailed, which is expressed in only the posterior compartments of embryos and imaginal discs, represses ci-D in these cells.

Pharmacokinetic analysis of blood distribution of intravenously administered 153Gd-labeled Gd(DTPA)2- and 99mTc(DTPA) in rats

Rat plasma distribution data obtained following IV administration of 99mTc(DTPA) alone or after co-administration of 99mTc(DTPA) and 153Gd-labeled Gd(DTPA)2- at 0.001, 0.1, and 1.0 mmol Gd/kg were evaluated using compartmental modeling techniques. A three-compartment open model was found to fit the data significantly better (P less than 0.01) than a two- or four-compartment open model. This model incorporates and links the plasma and urine data and includes a delay to account for the transit time through the kidneys/ureters. The two nonplasma compartments of the model were assumed to be related to rapidly and slowly equilibrating tissues. Tc(DTPA) and Gd(DTPA)2- had nearly identical pharmacokinetic profiles in plasma and the rate constants were essentially the same. No significant dose dependent pharmacokinetic differences were found for the range of Gd(DTPA)2- doses tested. Simulations of the proposed three-compartment model were used to generate concentration-time curves for each of the three compartments.

Creatine kinase activity in sickle cell disease

Creatine kinase activity was measured in 28 patients in the steady state of sickle cell disease and ranged from 4-45 IU/l, comparable with that found in healthy adult caucasians. Creatine kinase activity was also measured in 14 patients admitted consecutively for the treatment of vaso-occlusive sickle cell crises. Creatine kinase activity remained within the normal range in eight of these 14 patients throughout their admission; none had muscle pain or a chest syndrome. In the remaining six, three with muscle pain and three with a chest syndrome, increased activity was found on one or more days. A further 17 patients with vaso-occlusive sickle cell crises, associated with muscle pain, were studied. Creatine kinase activity was significantly raised in all 17, the mean creatine kinase activity for men was 578.8 IU/l and 210.6 IU/l for women, with the highest values (up to 1790 IU/l) found in those who had exercised before admission. Measurement of creatine kinase activity may therefore be a useful marker of muscle perturbation due to sickling.

Transcriptional regulation of immunoglobulin heavy chain and T-cell receptor beta chain genes

We have identified factors that bind to functionally important regions in IgH chain promoters and enhancer. One promoter factors is identical to u-EBP-E, an enhancer binding protein. Several promoter-binding proteins are present preferentially in either B cells or fibroblasts although most enhancer-binding proteins have a ubiquitous distribution. Additional characterization of these factors will further our understanding of the mechanisms by which IgH promoters and enhancers interact to achieve B-cell restricted and developmental stage-specific expression of IgH genes. The identification of a TCR beta chain enhancer will allow us to pursue similar questions with respect to the regulated expression this locus.

Purified mu EBP-E binds to immunoglobulin enhancers and promoters

We describe the purification to apparent homogeneity of the murine immunoglobulin heavy-chain (IgH) enhancer-binding protein mu EBP-E from murine plasmacytoma cells by ion exchange and affinity chromatography. Glycerol gradient sedimentation, UV cross-linking, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis confirm that mu EBP-E is a 45-kilodalton molecular mass protein. Orthophenanthroline-copper chemical nuclease footprinting with purified protein has identified high-affinity binding sites for mu EBP-E within the IgH enhancer at the previously identified site E and at sites within IgH promoters and in the kappa light-chain enhancer. Equilibrium binding studies indicate that the dissociation constants for mu EBP-E binding to site E within the enhancer and to a binding site within the V1 heavy-chain promoter are quite low, about 2 x 10(-11) M. Comparison of four mu EBP-E recognition sequences detects only limited sequence similarity among binding sites.

Water quality control trials: statistical tables for direct comparison between membrane filtration bacterial counts and the multiple tube method with a description of the bacteriological method

Experiments in the quality control of water samples are being conducted in the Public Health Laboratory Service and the water industry in the United Kingdom. The number of distributions which have been made is 7 and 92 laboratories are now participating. The methods used for preparing and distributing samples are described. Some participating laboratories use the multiple tube method and some use membrane filtration to assess the presence of coliforms and Escherichia coli. The results are, therefore, a mixture of estimated numbers and direct colony counts. In order to compare results from these two different laboratory methods statistical tables have been compiled to show the most likely multiple tube result corresponding to each colony count. Tables relating to two commonly used tenfold dilution series are presented. To illustrate how these tables may be used we present results from a typical quality control distribution. The analyses of these results are generally satisfactory but show a tendency for lower counts using the membrane filtration method and more false negative results with E. coli counts.

Surgical procedures in patients during the tenth decade of life

The purpose of this study was to determine the outcome of major surgical procedures in patients 90 years of age or older. The records of 46 patients in this age group who underwent surgical procedures were reviewed to determine the outcome and the postoperative quality of life. Overall, the perioperative mortality was 20%. Mortality was not influenced by such risk factors as diabetes mellitus, chronic obstructive pulmonary disease, renal failure, quantity of blood loss, duration of procedure, or total number of hospital days. However, patients with heart disease had a significantly higher mortality rate (78%). Overall, 39% of the patients experienced a subjective deterioration in their mental status after surgery. Of those patients who were ambulatory before surgery, 73% were ambulatory after surgery. Although this study indicates that the perioperative mortality is high and mental status changes frequent in this very elderly age group, the quality of life and longevity of the majority of these patients are good, and vigorous surgical intervention appears warranted.

Preliminary pulsatile flow bench validation of a thermodilution right ventricular ejection fraction system

A preliminary Pulsatile Flow Bench validation of the REF-1 Right Ventricular Ejection Fraction (RVEF) computer and catheter system was performed to determine the accuracy of the current REF-1 system. These results reflect the accuracy of the current REF-1 system and not the final REF-1 system that will be released at a later date. The Pulsatile Flow Bench cardiac output and ejection fraction ranges included in this study are 1 to 6 Lpm and 15% to 60%, respectively. Currently, plans are being made to increase the flow bench cardiac output range to 10 Lpm with ejection fractions up to 70%. The results of this study show a correlation coefficient of 0.94 (adjusted R-square) between flow bench ejection fractions and REF-1 system ejection fractions. Also, the correlation coefficient between flow bench cardiac output and REF-1 system cardiac output was determined to be 0.99 (adjusted R-square).

Multiple DNA sequence elements are necessary for the function of an immunoglobulin heavy chain promoter

Sequences required for the function of the mouse V1 immunoglobulin heavy chain variable-region (VH) promoter were identified by transient transfection of the normal and mutated promoters into plasmacytoma cells. Our results identify four regions required for normal promoter function: (i) the octamer ATGCAAAT, previously identified by others; (ii) a heptamer, CTAATGA; (iii) a pyrimidine-rich region; and (iv) a region between positions -125 and -251 relative to the transcription start site. Sequence analysis of 19 mouse and human VH 5' flanking regions shows that the heptamer and pyrimidine stretch are strongly conserved. We have also demonstrated that the octamer functions in an orientation independent manner in the VH promoter.

Effect of reduced food intake on blood levels of a hypertensive factor in spontaneously hypertensive rats

We have previously demonstrated the existence of an active component(s) of extracts prepared from rat erythrocytes that stimulates the in vitro uptake of calcium in aortic rings and induces a sustained elevation in the blood pressure of normotensive rats. The apparent concentration of the calcium stimulatory component and the responsiveness of aortic rings to stimulation of calcium uptake by the compound is exaggerated in adult spontaneously hypertensive rats (SHR) compared with normotensive controls. Although no effect was observed on tissue responsiveness to the compound, a decrease in the concentration of the compound was observed in the blood of adult SHR subjected to dietary manipulation designed to blunt the elevation of blood pressure. These data suggest that blood concentration of the active compound may be influenced by external stimuli such as dietary manipulation.

The herpes simplex viruses: the facts health professionals need to know

Herpes labialis and herpes genitalis are described, including the symptoms, complications, treatment, and research of the disease. The article explains how transmission or contraction of the herpes virus occurs, particularly in the hospital setting, and how it can be avoided by the health professional.

The effect of oral potassium supplements on plasma potassium in normokalaemic and hypokalaemic patients

Thirteen out of 44 patients taking bendrofluazide 10 mg daily became hypokalaemic over a period of three months. Oral potassium supplements of 3.6 grams daily (48 mmol) given in addition to bendrofluazide for a further period of 3 months raised plasma potassium level significantly in hypokalaemic patients only. We conclude that where patients on diuretic therapy are followed up with plasma potassium measurements, it is generally necessary to prescribe oral potassium in the presence of hypokalaemia only.