Assessment in severe dementia: the Guy's Advanced Dementia Schedule

Previous findings suggest that severely demented subjects are often capable of responding in some ways to stimulation. This study describes the development of a schedule which can discriminate between subjects on the basis of their responses to a range of objects of varying familiarity. The schedule includes extensive prompting to elicit a range of responses from simple taking of objects through to naming and using. The measure was found to be reliable and valid against the Clifton Assessment Procedures for the Elderly and the Mini-Mental State Examination. Scores were able to discriminate between subjects scoring 0 on the Mini-Mental State Examination. It is suggested that scores on the schedule may reflect residual cognitive capacities and orientation to the environment and as such this measure could prove useful to a range of future studies.

The abstinence violation effect in sex offenders: a reformulation

It is argued that the central issue in the treatment of sexually aggressive behavior is the tendency to relapse shown by offenders. A model of the relapse process is presented along with what is described as its central feature, the abstinence violation effect (AVE). This construct is critically examined and its shortcomings identified. A brief description of Weiner's attributional theory is provided and this is used to reformulate the AVE. The advantages of the reformulated AVE are described, as are the clinical implications. Suggestions are then made for future research.

Applications and limitations of vitreoretinal biopsy techniques in intraocular large cell lymphoma

The cases of 4 patients with clinical signs of intraocular large cell lymphoma are described. Initial cytopathologic examination of vitrectomy specimens failed to establish the malignant character of the vitreous infiltrates. Three of the four patients eventually developed solid central nervous system tumors, intracranial biopsy samples of which revealed large cell lymphoma, 13 months to 42 months after initial examination. In one patient, transscleral retinochoroidal biopsy confirmed the diagnosis at the same time as negative vitreous cytologic examination. Results of cytopathologic examination alone of vitreous biopsy specimens may not be sufficient to make a diagnosis in certain cases of large cell lymphoma that are subsequently documented by CNS biopsy. Careful attention should be paid to the handling, processing, and interpretation of vitrectomy specimens from patients suspected of having intraocular large cell lymphoma. Consideration should be given to immunocytologic staining and interpretation by centers that are highly experienced in vitreous cytopathology.

Liposome suppression of proliferative vitreoretinopathy. Rabbit model using antimetabolite encapsulated liposomes

The effects of the antimetabolites, cytarabine (Ara-C) and 5-fluorouridine 5'-monophosphate (FUMP), encapsulated in multivesicular liposomes on formation of vitreous fibroproliferative membranes in New Zealand white (NZW) rabbits were studied. In pharmacokinetic studies, the drug half-life in the vitreous cavity was 124 hr after intravitreal administration of 1.0 mg of FUMP in liposomes. By contrast, the drug half-life after a single injection in nonliposome-treated controls was only 4.5 hr. In a heterologous dermal fibroblast model of proliferative vitreoretinopathy (PVR), there was a 92% decrease in frequency of tractional retinal detachments in rabbits receiving a single intravitreal injection of liposome-encapsulated 0.1 mg of FUMP compared with controls receiving liposomes without drug. A dose of 1 mg of Ara-C in liposome-treated rabbits was associated with only a 46% reduction in tractional detachment compared with controls. Multivesicular liposome-encapsulated FUMP may be useful for inhibiting formation of fibroproliferative membranes in the vitreous after vitreoretinal surgery.

Fine mapping of probes in the adenomatous polyposis coli region of chromosome 5 by in situ hybridization

The gene for adenomatous polyposis coli has been localized to 5q21-22. We have mapped six probes from this region using isotopic or nonisotopic in situ hybridization. Using tritium-labeled probes we localized II227 (D5S37) to 5q14-15 and ECB27 (D5S98) to 5q21. Following hybridization with biotin-labeled probes, the positions of signals along the chromosomes were measured as fractional length relative to the length of the chromosome arm from centromere to qter (FLcen-qter). Ninety-five percent confidence limits, compared with standard karyotypes, provided the corresponding band localization. By this method we localized Cllpll (D5S71) to FLcen-qter 0.407-0.452 (5q21.1-21.3), ECB27 to FLcen-qter 0.426-0.473 (5q21.3), YN5.48 (D5S81) to FLcen-qter 0.459-0.496 (5q21.3-22.2), and ECB134 (D5S97) to FLcen-qter 0.509-0.533 (5q22.3-23.1). ECB220 had three sites of hybridization, a major site at FLcen-qter 0.460-0.492 (5q21.3-22.1) and minor sites at FLcen-qter 0.299-0.339 (5q14.3-15) and FLcen-qter 0.629-0.691 (5q23.3-31.2). We have shown that the chromosome 5 breakpoint in a t(5;15) translocation from a patient with Gardner's syndrome (GM03314) is between Cllpll and ECB27. Linkage data are presented suggesting that ECB27 is located on the same side of the APC locus as II227. These and published results including data on several constitutional deletions (M, SD, and brothers PW and ND) give a probable order of [cen] - [II227, proximal SD breakpoint] - [Cllpll] - [proximal PW/ND, M breakpoint(s), GM03314 breakpoint] - [ECB27] - [APC] - [YN5.48] - [distal PW/ND breakpoint] - [ECB134] - [distal M breakpoint] - [qter]. The major site of ECB220 appears to be between ECB27 and the distal PW/ND breakpoint; the distal SD breakpoint is distal to YN5.48.

Functional assessment in severely demented patients

The Brighton Clinic Adaptive Behaviour Scale was administered to a group of severely demented patients, resulting in a range of scores. The scale was found to be reliable and validated against the Clifton Assessment Procedures for the Elderly Behaviour Rating Scale and psychiatric ratings. The scale is likely to prove useful to clinicians and researchers.

Effects of a diabetogenic strain of encephalomyocarditis (EMC) virus on protein synthesis in mouse islets of Langerhans

The effects of a diabetogenic strain of encephalomyocarditis (EMC) virus on total protein and insulin biosynthesis in mouse islets of Langerhans have been studied in tissue culture. In dispersed mouse islets, the rates of protein biosynthesis were assessed by measuring the incorporation of [3H]leucine into proteins. In infected dispersed islets incubated in 20 mM-glucose, both insulin and total protein biosynthesis were decreased at 6 h; only insulin biosynthesis was significantly decreased at 3 h. In whole islets, EMC virus brought about a decrease in glucose-stimulated protein and insulin biosynthesis as early as 2 h after infection without concomitant effects on insulin release. This inhibition of protein biosynthesis was still apparent at 20 h post-infection, at which time insulin release was found to be markedly elevated, and the islet insulin content was moderately decreased. At 44 h post-infection, glucose-induced insulin biosynthesis was preferentially inhibited. Infected islets at this later time point also displayed elevated levels of insulin release, and a marked loss of islet insulin content. When insulin mRNA and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA levels were assessed by dot-blot hybridization using appropriate cDNA probes, levels of insulin mRNA were shown to decrease steadily during the first 20 h of infection, in contrast with the levels of GAPDH mRNA. At 44 h post-infection, both types of mRNA were markedly decreased. It is suggested that there is an initial early 'shut-off' of protein synthesis without other detectable changes in islet function. This is followed by a phase where both insulin mRNA levels and insulin synthesis are dramatically decreased.

The RAD50 gene, a member of the double strand break repair epistasis group, is not required for spontaneous mitotic recombination in yeast

Mutations in the RAD50 gene of Saccharomyces cerevisiae have been shown to reduce double strand break repair, meiotic recombination, and radiation-inducible mitotic recombination. Several different point mutations (including ochre and amber alleles) have been previously examined for effects on spontaneous mitotic recombination and did not reduce the frequency of recombination. Instead, the rad50 mutations conferred a moderate hyper-rec phenotype. This paper examines a deletion/interruption allele of RAD50 that removes 998 of 1312 amino acids and adds 1.1 kb of foreign DNA. The results clearly indicate that spontaneous mitotic recombination can occur in the absence of RAD50; in fact, the frequency of recombination is elevated over the wild-type cell. One possible interpretation of these observations is that the initiating lesion in spontaneous recombination events in mitosis might not be a double strand break.

Coxsackie B4 viruses with the potential to damage beta cells of the islets are present in clinical isolates

Infections with Coxsackie viruses (especially Coxsackie B4) are thought to be involved in the pathogenesis of diabetes. Many interdependent variables determine the outcome of an infection with a Coxsackie virus, one of them being the tropism of the virus for a specific tissue. The extent to which Beta cell tropic variants of Coxsackie B4 virus occur naturally was assessed. Human isolates of this virus were tested in an in vitro system in which elevated insulin release from infected islets incubated at a non-stimulatory (2 mmol/l) glucose concentration appears to be related to viral attack. Using this technique, 8/24 isolates tested, impaired secretory function in mouse islets. Some strains of Coxsackie B4 virus, therefore, will directly infect mouse islets in vitro leading to changes in islet cell function. In conclusion, these findings confirm that variants of Coxsackie B4 virus with the potential to damage Beta cells occur quite frequently in the natural population. In certain circumstances the damage they inflict on Beta cells may cause destruction of these cells, or precipitate overt diabetes.

In vivo infection of mice with Coxsackie B4 virus induces long-term functional changes in pancreatic islets with minimal alteration in blood glucose

The long-term effects of Coxsackie B4 (CB4) infection of mice on pancreatic islet function were investigated. Mice were inoculated with various strains of CB4 virus and 2, 3 and 6 months later islet insulin synthesis and release from isolated islets were measured. Insulin release at basal glucose concentration (2 mmol l-1) was higher in islets from mice inoculated with pancreas-adapted CB4 strains than in control islets or those from mice inoculated with tissue culture-adapted CB4. Thus, two strains of pancreas-adapted virus (P11 and P12) increased basal insulin release by 72% compared with control islets (p less than 0.05) 1 month after inoculation. Another strain (P13) increased insulin release by 421% at 3 months post-inoculation (p less than 0.01) and by 192% at 6 months (p less than 0.05) compared with control islets. The rate of total protein synthesis in islets from P11-inoculated mice 1 month later was 61% lower than in control islets at basal glucose levels (p less than 0.001), and was 25% lower at 20 mmol l-1 glucose (p less than 0.01). There were no significant changes in protein synthesis in islets from infected mice at 3 or 6 months. The abnormal insulin release occurred with minimal changes in random blood glucose concentrations. Histologically the islets were unchanged and there were no detectable islet cell antibodies. These results show that CB4 infection may lead to a persistent metabolic dysfunction in islets with minimal changes in blood glucose levels.

Metabolism of 4-benzamido-1-[4-(indol-3-yl)-4-oxobutyl]piperidine in rats and monkeys

1. Studies on the absorption, biotransformation and excretion of the potential anti-hypertensive agent 4-benzamido-1-[4-(indol-3-yl)-4-oxobutyl]piperidine (Wy 23699) have been carried out in monkeys and rats. 2. Absorption of the drug in both species was good, as shown by the relative proportions of radioactivity found in the urine after i.v. and oral dosage. 3. Biotransformation was extensive in both species, but the major routes of metabolism were different. In monkey N-dealkylation gave rise to 4-benzamidopiperidine as the principal metabolite; two other minor metabolites were identified as 2-oxo-4-benzamidopiperidine and 4-benzamido-1-[4-(5-hydroxyindol-3-yl)-4-oxo-butyl]piperidine. In the rat, this latter compound (as its conjugate) was the major metabolite; small amounts of benzamidopiperidine but not 2-oxobenzamidopiperidine were found. 4. There was a marked species difference in the route of excretion. Monkeys excreted greater than 60% dose of the drug in the urine, while rats excreted only 19% by this route. This may reflect the species difference in routes of metabolism, metabolic scission of the drug molecule seen in the monkey favouring renal rather than biliary excretion. The toxicological consequences of this are discussed.

Muscle state: reaction and movement time in elbow extension

Eleven subjects reacted to a randomly timed auditory stimulus by extending their right elbows as rapidly as possible under agonist muscle normal state, pretensed and relaxed conditions. Integrated electromyography (emg) was used to validate and quantify muscle state. Total reaction time was divided into premotor reaction time and motor reaction time components, and elbow movement time was measured under all conditions. Significant differences were observed in the integrated emg between the pretensed and relaxed experimental conditions. Differences were observed in total reaction time and premotor time, but not in motor reaction time or movement time.

Isolation of a factor with toxohormone properties from mouse tumor cells in culture

A small molecular weight factor with potent toxohormone activity was recovered from the serum-free culture supernatant of mouse MBQA fibrosarcoma cells. The factor depressed plasma-bound iron levels in mice and inhibited cell-free protein synthesis in microgram doses. Preliminary characterizations suggest that the active material is a small peptide.

Studies with chicks on the growth depressing factor(s) in faba beans (Vicia faba L. var. minor)

The growth response of broiler chicks was improved when they were fed diet containing high levels (greater than 85%) of heat treated as compared to raw faba beans. Pelleting and microwave treatment of faba beans containing 10% moisture resulted in maximal improvements in chick growth rates and feed efficiency of only 6% and 8%, respectively. Steam autoclaving (121 degrees for 20 minutes), extrusion (130 degrees or 152 degrees), or microwave treatment of faba beans containing 18% added water resulted in maximal improvements of 16% in growth rates and 19% in feed: gain ratios. the above study, a time course study of the relationship between faba beans autoclaving time anc chick growth response, and studies with individual faba bean fractions (starch isolate and protein isolate) suggests that processing improves the utilization of faba bean mainly through its effects on components associated with the protein and possibly the hull portions of faba beans. The utilization of faba bean starch is not improved with processing. Although the nature of the growth depressing factor(s) has not been established, the results from this study indicated that the major component does not appear to be a tryspin inhibitor, hemagglutinin, some other heat labile protein, or vicine.

Production of ethylene and other volatiles and changes in cellulase and laccase activities during the life cycle of the cultivated mushroom, Agaricus bisporus

Nine volatile hydrocarbons, as well as methyl chloride, carbonyl sulphide and carbon disulphide, have been identified by mass spectrometry as products of Agaricus bisporus in the compost used in comerical mushroom beds. Of these, only ethylene showed a pattern of production that could be correlated with developmental phases of the crop, high levels being produced whenever fruit bodies were rapidly enlarging. In laboratory flask cultures, under controlled conditions, high levels of ethylene occurred whenever young fruit bodies entered the expansion phase. The enhanced rate of ethylene production continued over several days, irrespective of whether fruit bodies were removed. Production occurred within the colonized compost; no ethylene was evolved by the fruit body itself. When the first fruit bodies expanded, either in beds or culture flasks, laccase levels in the compost fell and those of a beta-1,4-glucanase (cellulase) rose. The enzyme switch occurred once only, during maturation of the first fruit bodies, whereas an elevated ethylene production was associated with each occasion when fruit body maturation took place. The low level of laccase and high of cellulase characterized the whole of the reproductive stage of A. bisporus, whereas the phasic periods of high ethylene production distinguished between periods of fruit body maturation and intervening resting periods.

The maxillofacial unit

Images