Magnetic resonance imaging in schizophrenia: relationship with clinical measures

Relationships were examined between clinical features of schizophrenia and cerebrospinal fluid (CSF) volume in brain obtained by magnetic resonance imaging (MRI) in a sample of 59 patients. The volumes of the cerebral hemispheres and CSF were measured with a computer program designed to separate reliably neural tissue from CSF. The CSF to cranial volume ratios were related to history, symptom profile and outcome functioning. Earlier age of onset was associated with higher sulcal CSF ratio, r = -0.40. The anatomic measures were unrelated to symptom severity. However, patient subtypes differed in the laterality of measures. Higher left hemispheric ratios were seen in patients with severe negative symptoms, and left predominance of ventricular relative to sulcal ratios was associated with the presence of hallucinations and delusions. The results suggest that while higher CSF is related to earlier age of onset, the clinical symptoms are more related to its lateralization. This is consistent with the hypothesis that schizophrenia is a lateralized brain disease.

The collection of general practice data for psychiatric service contracts

A three-month prospective collection of primary care data from general surgery attendances in an inner London Health District was carried out to inform the setting of contracts for psychiatric services. This involved 21 general practitioners (GPs) selected from a total of 102 in the District. Information was collected on mental health disorders detected by GPs among the attenders, the resultant volume of care provided by the GPs, the referrals made to secondary care and other agencies, and the types of care identified by the practitioners as appropriate for a patient but which are currently not accessible or available. We found that 45.9 per cent of all patients (17,319/37,733) registered with the 21 GPs were seen in three months. There was an overrepresentation of White and Black Caribbean patients and an under-representation of Bangladeshi, Chinese, Black African and Black Other patients in the study population. Mental health disorders were detected in 13.3 per cent (2304) of all attenders. The commonest problems were depression (17.7 per cent), acute stress reaction (15.5 per cent), anxiety (15.1 per cent), drug abuse (7.2 per cent), schizophrenia (5.8 per cent) and alcohol abuse (5.3 per cent). It was found that 37.3 per cent (860) of all attenders received medication, 66.5 per cent (1532) were counselled by the GPs and only 4.4 per cent (102) were referred to a psychiatrist; 16.3 per cent (375) of those with mental health disorders were identified by the GPs as having a service need which the District's psychiatric service could not meet.(ABSTRACT TRUNCATED AT 250 WORDS)

Phase-I trial of Thiotepa, granulocyte-macrophage colony-stimulating factor and prednisone or pentoxifylline in patients with refractory solid tumors

In a phase I trial, 13 patients with refractory solid tumors received thiotepa, granulocyte-macrophage colony-stimulating factor (GM-CSF), and either prednisone or pentoxifylline (PTX) on alternate cycles. The prednisone and PTX were administered in an attempt to ameliorate toxicity related to GM-CSF. Of the first six patients treated at a thiotepa dose of 60 mg/m(2), five experienced grade 3 or 4 thrombocytopenia and four grade 2 or greater leukopenia. One of these patients died secondary to E. coli sepsis. Seven patients received a thiotepa dose of 50 mg/m(2), with one experiencing grade 3 thrombocytopenia and another grade 3 leukopenia. The latter patient died secondary to presumed sepsis. The five remaining patients at the 50 mg/m(2) dose did not experience greater than grade 1 hematologic toxicity. Serum tumor necrosis factor levels were not increased by GM-CSF. Patients in this trial were not evaluable for amelioration of GM-CSF toxicity as too few received a second cycle of treatment. We conclude that thiotepa doses greater than 50 mg/m(2) are not tolerated due to severe thrombocytopenia which is not diminished by the administration of GM-CSF.

High-speed acousto-optic mapping modulator for the generalized Hough transform

We describe a high-speed acousto-optic Hough-transform mapping modulator. This mapping modulator generates any θ slice of the straight line Hough-transform and one-dimensional slices of generalized Hough transforms (e.g., for circles and ellipses). We derive the mapping functions for the acousto-optic modulator for both circle and ellipse Hough transforms and show simulations of generalized Hough transforms using both functions. We also describe how the mapping modulators can compute Hough transforms for nonanalytically describable inputs.

Taurolin for the prevention of parenteral nutrition related infection: antimicrobial activity and long-term use

A case is described in which bis (1, 1 dioxoperhydro-1, 2, 4-thiadiazinyl-4-) methane (Taurolin) has saferly been administered on a long term basis to prevent recurrent sepsis in a patient receiving parenteral nutrition. A 26-year-old male with Crohn's disease receiving parenteral nutrition suffered repeated episodes of sepsis and developed an infected intra-atrial thrombus despite repeated courses of antimicrobial chemotherapy and surgical intervention. Continued parenteral nutrition was essential du5e to intestinal failure. Taurolin was administered in the parenteral feed, as a 0.3% solution, to prevent recrudescent and recurrent infection. This concentration was shown, in vitro, to be bactericidal to a variety of pathogenic organisms. No recurrence of sepsis, nor any evidence of side effects was observed throughout the 12 month period of Taurolin administration. After 12 months the taurolin was discontinued and within 2 weeks the patient was re-admitted with recurrent septicaemia. Following re-introduction of Taurolin the infection was controlled and the patient remains well. In our experience the addition of taurolin to the nutritive feeds of a patient at risk of sepsis is a safe and effective method of preventing recurrent sepsis.

Acidic residues are involved in substrate recognition by two soluble protein tyrosine phosphatases, PTP-5 and rrbPTP-1

The mechanisms for substrate recognition by two cytoplasmic protein tyrosine phosphatases, PTP-5 and rrbPTP-1, were investigated. Phosphorylation sites on tyrosine-phosphorylated casein, a model PTP substrate, were characterized. Two peptides based on casein phosphorylation sites and one peptide based on the tyrosine phosphorylation site of reduced, carboxamidomethylated and maleylated (RCM) lysozyme were tested as PTP substrates. The three peptides were dephosphorylated by PTP-5 and rrbPTP-1 at rates comparable to those of the corresponding sites on the intact proteins. This indicates that peptides based on the two model PTP substrates, casein and RCM-lysozyme, contained all or most of the structural information necessary for PTP-5 and rrbPTP-1 substrate recognition. Structural elements required for substrate recognition by PTP-5 and rrbPTP-1 were also investigated. Km values for dephosphorylation of three simple aromatic phosphate esters (phosphotyrosine, p-nitrophenyl phosphate, and phenyl phosphate) by rrbPTP-1 were about 5000-fold higher than those obtained for the peptide and protein substrates. This indicates that recognition of protein and peptide substrates involves structural elements in addition to the phosphate group and the aromatic tyrosine ring of phosphotyrosine. Analysis of the effects of truncations and Ala for polar substitutions on the reactivity with PTP-5 and rrbPTP-1 of peptides based on casein, RCM-lysozyme, and angiotensin II indicated that Asp or Glu within the first five residues on the N-terminal side of phosphotyrosine increased peptide reactivity with both PTP's. Asn residues were unable or only weakly able to substitute for Asp residues.(ABSTRACT TRUNCATED AT 250 WORDS)

Epidural catheters. Breaking and extraction forces

The forces required to break and to remove catheters from epidural spaces were investigated. Provided the patient's back is fully flexed and a slow steady pull is applied to the epidural catheter, the extraction forces required at both thoracic and lumbar levels are well below the minimum force required to break the same catheters.

Comparison of intubation following propofol and alfentanil with intubation following thiopentone and suxamethonium

We have compared a rapid sequence induction of anaesthesia using propofol 2 mg.kg-1 and alfentanil 50 micrograms.kg-1, with a standard technique using thiopentone 5 mg.kg-1 and suxamethonium 1 mg.kg-1. The incidence of complications, and the quality of conditions for intubation, were similar in both groups. The patients receiving propofol and alfentanil showed a significant decrease in blood pressure and heart rate following induction (p < 0.01), whereas the group receiving thiopentone and suxamethonium showed a significant increase in blood pressure and heart rate following induction (p < 0.01). The use of propofol and alfentanil provided a satisfactory alternative to thiopentone and suxamethonium for a rapid sequence induction of anaesthesia.

Nosocomial spread of Staphylococcus aureus showing intermediate resistance to methicillin

A nosocomial outbreak of infection and colonization involving six patients and caused by a strain of Staphylococcus aureus showing intermediate resistance to methicillin (MIC = 4-8 mg l-1) is described. The outbreak was associated with skin-carriage of the epidemic strain by a nurse suffering from severe eczema. The reduced susceptibility of the outbreak strain to methicillin was associated with beta-lactamase production. Elimination or inhibition of beta-lactamase activity produced a two-fold decrease in methicillin MIC. There was no evidence for the presence of either penicillin-binding protein 2a or the corresponding mec gene, which mediate resistance in fully methicillin-resistant strains.

Hospital food hygiene: the application of Hazard Analysis Critical Control Points to conventional hospital catering

The Hazard Analysis Critical Control Point (HACCP) concept is a preventive approach to quality control. It is based on a logical, structured exploration of potential hazard points in a food operation and the introduction of control and monitoring measures. HACCP studies have been extensively applied to manufacturing systems. It has been difficult to extend this detailed systematic analysis to conventional catering, partly due to the wide range of foods being processed. We describe here the application of HACCP methods to a hospital department that uses conventional catering methods. Basic principles, based on the work flow and the range of products are established. The guidelines produced can be applied to any kitchen using similar catering methods. Examples of log charts used for monitoring are provided.

Laboratory comparison of the cannulated Herbert bone screw with ASIF cancellous lag screws

The compression produced by and the resistance to pullout of the 6.5 mm cannulated Herbert screw were compared with those of ASIF headed screws. The latter were tested with and without washers and in the following sizes: 4.5 mm cortical, 6.5 mm cancellous with a 16 mm threaded segment, and 6.5 mm cancellous with a 32 mm threaded segment. Polyurethane foam was used as a substitute for cancellous bone and ASIF artificial bone for corticocancellous bone. The compression produced by a cancellous lag screw with a washer was significantly greater than that produced by a Herbert screw of equivalent size (p < 0.05). When the screws were tested using the corticocancellous composite the ASIF cancellous screw without a washer produced significantly greater compression (p < 0.05); when used with a washer the difference was highly significant (p < 0.001). The dual pitch Herbert screw is not appropriate for the management of fractures in which compression is of greater importance than the need to avoid prominence of the screw head.

Serum calcium, parathyroid hormone, and vitamin D status in children and young adults with sickle cell disease

The concentrations of serum calcium, parathyroid hormone (PTH), 25 Hydroxyvitamin D (25OHD), and 1,25 Dihydroxyvitamin D (1,25(OH)2D) were determined in 99 Saudi patients with sickle cell disease and in 104 matching healthy controls. Serum calcium and 25OHD were significantly lower in the patients, with 14% and 12% of them had serum calcium and 25OHD concentrations, respectively, below the normal range. PTH was significantly higher in the patients, with 31% having values above the normal range. There was no significant difference between patients and controls in regard to 1,25(OH)2D. There was a significant inverse correlation of 25OHD with PTH and a direct correlation of PTH with 1,25(OH)2D. Dietary intake of calcium and vitamin D was adequate in both patients and controls. The results indicate that sickle cell patients have hypocalcaemic tendency associated with supranormal PTH, and imply impaired intestinal absorption of calcium and vitamin D leading to a disturbed calcium metabolism which might contribute to the skeletal changes seen in sickle cell disease.

Proposed role of phosphatidic acid in the extracellular control of the transition from G2 phase to mitosis exerted by epidermal growth factor in A431 cells

Epidermal growth factor (EGF) has been shown to cause an inhibition of A431 cells in G2 phase within approximately 10 min, i.e., shortly before mitosis (Kinzel et al., Cancer Res., 50: 7932-7936, 1990). This system has been used to study the proposed role phospholipid metabolites, particularly phosphatidic acid (PA), may play (Kaszkin et al., Cancer Res., 51: 4328-4335, 1991) in the extracellular control of cells at the physiological restriction site in G2 phase. A431 cells responded to EGF with a dose-dependent formation of phosphatidic acid (PA) which correlated with the dose-dependent G2 delay as well as with their time courses. The G2 delay induced by EGF as well as PA mobilization were effected in conditioned medium or in fresh medium containing bovine serum albimun instead of serum, i.e., under the conditions necessary for precursor studies to be carried out. The major pathway of PA formation was probably via phospholipase C-mediated breakdown of phosphatidylinositol and diacylglycerol kinase: (a) the dose response of PA formation correlated with that of total inositol phosphate accumulation; (b) little diacylglycerol was found and then only at a high EGF concentration; (c) prelabeling with [1-14C]arachidonic acid resulting in a large specific labeling of phosphatidylinositol led to an EGF-induced, dose-dependent formation of radioactive arachidonyl-PA (correlated with that of total PA and inositol phosphate), but in the presence of a primary alcohol not to the formation of radioactive phosphatidylalcohol; (d) prelabeling with [1-14C]oleic acid led to the EGF-induced formation of labeled PA, which in the presence of a primary alcohol was only slightly reduced to the advantage of very low levels of labeled phosphatidyl alcohol, thus demonstrating that an EGF-effected activation of phospholipase D did occur but contributed little to the general PA level. An alternative mobilization of PA was attempted with the phorbolester 12-O-tetradecanoylphorbol-13-acetate (TPA), which was shown to activate phospholipase D in A431 cells and to elicit PA from a phospholipid pool which was not significantly labeled with radioactive arachidonic acid. The TPA-induced degree of PA formation and of the G2 delay correlated. Both phenomena were considerably larger with fresh medium containing 0.5% bovine serum albumin instead of serum than in conditioned medium.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of lithium chloride on ornithine decarboxylase activity in rat adrenal

The effects of lithium chloride on ornithine decarboxylase (ODC) activity were compared in the adrenal and kidney of control (saline treated) and prolactin-treated rats. ODC activity was decreased in kidney of both groups of animals, the magnitude of the effect of lithium in the hormone-treated group varying with the time of administering the lithium relative to prolactin. The response in the adrenal was quite different. Following treatment with LiCl, there was a gradual increase in ODC activity from a low of 10-35 pmol CO2 x 30 min-1.mg protein-1 in control animals to values 20- to 30-fold greater at 5 h. In rats treated simultaneously with LiCl and prolactin, ODC activity was greater at 5 h than that observed in animals receiving either compound alone, indicating that their effects were additive. When LiCl was given 4 h after prolactin, i.e., 1 h before sacrifice, ODC activity decreased to a very low level at 5 h, as in other tissues. The increase in ODC activity in the adrenal following LiCl is of the same magnitude as the changes observed in tissues stimulated to undergo alterations in proliferation, differentiation, or metabolic or membrane activity by hormones and other external stimuli.

Expression cloning of a common receptor for parathyroid hormone and parathyroid hormone-related peptide from rat osteoblast-like cells: a single receptor stimulates intracellular accumulation of both cAMP and inositol trisphosphates and increases intracellular free calcium

Parathyroid hormone (PTH), a major regulator of mineral ion metabolism, and PTH-related peptide (PTHrP), which causes hypercalcemia in some cancer patients, stimulate multiple signals (cAMP, inositol phosphates, and calcium) probably by activating common receptors in bone and kidney. Using expression cloning, we have isolated a cDNA clone encoding rat bone PTH/PTHrP receptor from rat osteosarcoma (ROS 17/2.8) cells. The rat bone PTH/PTHrP receptor is 78% identical to the opossum kidney receptor; this identity indicates striking conservation of this receptor across distant mammalian species. Additionally, the rat bone PTH/PTHrP receptor has significant homology to the secretin and calcitonin receptors but not to any other G protein-linked receptor. When expressed in COS cells, a single cDNA clone, expressing either rat bone or opossum kidney PTH/PTHrP receptor, mediates PTH and PTHrP stimulation of both adenylate cyclase and phospholipase C. These properties could explain the diversity of PTH action without the need to postulate other receptor subtypes.

Implementing a computer system: issues for nurse administrators

Because more and more health care agencies are becoming computerized, nursing administrators need to increase their knowledge about computer systems. Specifically, they must have at least some basic knowledge regarding the purchase, implementation, and maintenance of systems, because they and their staff are ultimately affected by them. This article describes how one agency managed the implementation of a new computer system and the issues that the nurse administrator faced during this process.

Monoclonal anti-melanoma antibodies IKH-1 and IKH-2 which work on formalin-fixed, paraffin embedded tissues: characterization, clinical trials and comparative studies with HMB-45

Mouse monoclonal antibodies (MoAbs), IKH-1 and IKH-2, were produced against cloned human melanoma cells, KHm-6, which were cultured with 12-O-tetradecanoylphorbol-13-acetate (TPA) and processed by formalin fixation and alcohol dehydration (FFAD). According to the biochemical analysis, antigenic substances which reacted with IKH-1 were 34.0-60.0 kDa glycoproteins, and those which reacted with IKH-2 were 33.5, 34.5 and 36.0 kDa glycoproteins. Immunoelectron microscopy revealed that reaction products of IKH-1 were seen in some membranous vesicles, premelanosomes and cell membrane of TPA-treated KHm-6 cells, while IKH-2 recognized only premelanosomal structures. Immunohistochemical tests revealed that IKH-1 and IKH-2 have a high sensitivity (94.0% and 85.0%, respectively) to formalin-fixed, paraffin-embedded (FFPE) tissue sections of malignant melanomas. IKH-1 had a high specificity and IKH-2 and 100% specificity to FFPE tissue sections of melanocytic lesions.

Relationship between cholinesterase inhibition and thermoregulation following exposure to diisopropyl fluorophosphate in the rat

This study examined the relationship between inhibition of cholinesterase activity (CA) and thermoregulatory response in the rat following exposure to the organophosphate (OP), diisopropyl fluorophosphate (DFP). Male Long-Evans rats were injected with DFP dissolved in peanut oil in doses ranging from 0 to 1.5 mg/kg (s.c.). Colonic (Tcol) and tail skin temperature (Ttail) were recorded at 0, 1, 2 and 3 h post-injection. At 3 h post-injection the rat was sacrificed and a blood sample was taken by cardiac puncture and analyzed for CA. There was a biphasic dose effect of DFP on Tcol with slight but significant elevation in Tcol in the dose range of 0.01-0.5 mg/kg and a significant depression in Tcol at doses of 1.0 and 1.5 mg/kg. There was a dose-dependent fall in CA with DFP administration in the erythrocyte, plasma, and whole blood fractions. Hypothermia was associated with 80-87% inhibition in CA, whereas the elevation in Tcol was associated with 20-70% inhibition in CA. DFP also elicited significant elevations in Ttail. Overall, the data fail to demonstrate any clear relationship between inhibition of blood CA and thermoregulatory response following exposure to DFP. However, the elevation in Tcol following relatively low doses of DFP may be of relevance to the frequently reported symptom of fever in humans exposed to OP agents.

A G protein-linked receptor for parathyroid hormone and parathyroid hormone-related peptide

The complementary DNA encoding a 585-amino acid parathyroid hormone-parathyroid hormone-related peptide (PTH-PTHrP) receptor with seven potential membrane-spanning domains was cloned by COS-7 expression using an opossum kidney cell complementary DNA (cDNA) library. The expressed receptor binds PTH and PTHrP with equal affinity, and both ligands equivalently stimulate adenylate cyclase. Striking homology with the calcitonin receptor and lack of homology with other G protein-linked receptors indicate that receptors for these calcium-regulating hormones are related and represent a new family.

Volunteers for biomedical research. Recruitment and screening of normal controls

We examined the process of accruing healthy control subjects for biomedical research on brain function. Of 1670 responders to newspaper advertising, 23.1% were uninterested when learning more about the studies, and 50.9% of those remaining were found by structured telephone screening to meet exclusionary criteria for having a history of psychiatric, neurologic, or medical disease that might affect brain function. Of 312 volunteers passing the telephone screening who came to an in-person evaluation by a physician and agreed to participate, 49.7% were found to meet exclusionary criteria, and only 157 were admitted to the study. This underscores the importance of attending to the issue of screening and assessment of "normal volunteers." Alternative strategies should be considered for enriching the pool.

A proposed common mechanism by which phorbol esters and epidermal growth factor delay the progression from G2 phase to mitosis of HeLa cells through phospholipid metabolites

The phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA; also called phorbol myristate acetate) and epidermal growth factor both rapidly inhibit the transition of HeLa cells from G2 phase to mitosis in a reversible fashion with characteristics of a receptor-mediated response. It was proposed that an intracellular mediator was responsible for this inhibition. In searching for a common mediator elicited by the action of both ligands, the time course of generation of phospholipid metabolites was compared with the cell cycle response of the G2 cohort monitored by time lapse analysis. The time course and the degree of mobilization of diacylglycerols (DG) effected by TPA and by epidermal growth factor and that of phosphatidic acid correlated to a great extent with the onset and the duration of the G2 inhibition caused by both agonists. Further evidence for the proposed role of DGs and/or phosphatidic acid was obtained by the observation that membrane-penetrating 1,2-DG inhibited HeLa cells in G2 phase directly. The concentration of DG required correlated with that elicited by TPA or epidermal growth factor metabolically. This cellular response to 1,2-DG was also seen in cells after down-regulation of protein kinase C using TPA. The data indicate that cellular DG and/or phosphatidic acid may contribute to a restriction of cells in G2 phase possibly by changing membrane properties.

Extracting input-line position from Hough transform data

The Hough transform (HT) detects lines in an input but not their location. We describe a new way to determine the position of a line from HT data. The line position information is extracted from the shape of the HT pattern around the HT peak. Results are shown illustrating this algorithm on single- and multiple-line input images.

Effects of antioxidants and reduced oxygen tension on rat mammary epithelial cells in culture

Free radical damage has the potential to significantly affect the behavior of cells in culture. In this study the effects of antioxidants (superoxide dismutase, catalase, and vitamin E) and lowered oxygen tension (1% oxygen) on primary culture of rat mammary epithelial cells were examined. Rat mammary epithelial cells were dissociated in collagenase with or without the addition of antioxidants and low oxygen tension, then cultured for 10 d in rat-tail collagen gel matrix and fed with Dulbecco's modified Eagle's F12 medium supplemented with various hormones and growth factors. Growth potential of the mammary cells was enhanced when antioxidants and low oxygen tension were used, alone or in combination, during the cell dissociation period. Using antioxidants and low oxygen tension during the culture period failed to improve growth potential regardless whether cells were dissociated in standard conditions or with antioxidants and low oxygen tension. The use of antioxidants and low oxygen tension during the cell dissociation period also reduced the degree of keratinization of the cells after 10 d of culture. Using antioxidants and low oxygen tension during the cell culture period did not further reduce keratinization if antioxidants and low oxygen tension were used during the dissociation period, but were effective in reducing keratinization if cells were dissociated in standard condition. In this system, antioxidants and low oxygen tension reduced lipid peroxidation during the cell dissociation period. An iron chelator, desferal, can also reduce lipid peroxidation and enhance growth when used during cell dissociation, suggesting the enhanced growth potential by the addition of antioxidants and low oxygen to be due to the reduction of lipid peroxidation.

Successful treatment of Bacillus cereus infection with ciprofloxacin

Bacillus cereus is rarely a pulmonary pathogen but may cause pneumonia in immunocompromised patients. A patient with bronchiectasis and no recognisable immunodeficiency had this organism isolated during two infective exacerbations, once from respiratory secretions and once by blood culture. Ciprofloxacin treatment was effective on both occasions.

The influence of parenting stress and child behavior problems on parental estimates of expressive and receptive language development

This study examined the relative contributions of parental reports of child-related and parent-related stress to their estimates of expressive and receptive language skills on the Minnesota Child Development Inventory in 152 children referred to a communicative disorders clinic. Correlational analysis showed moderately high agreement between parental estimates and objective measures of expressive and receptive language ability. Multiple-regression analyses revealed that independent measures of language acquisition accounted for the greatest amount of variance in parental estimates of expressive and receptive language skills. Stressful child behavior accounted for a small but statistically significant proportion of the variance in estimates of expressive and receptive language skills. Parental stress, in contrast, did not contribute significantly to language estimates. These findings suggest that parents are able to formulate estimates of language development which are relatively independent of personal or child-related stressors.

Acute post-streptococcal glomerulonephritis

Acute glomerulonephritis is characterized by the presence of hematuria, proteinuria and edema, and often hypertension and acute renal failure. Acute post-streptococcal glomerulonephritis is the prototypic disease of acute glomerulonephritis. It is seen after both streptococcal pharyngeal and skin infections with a latency period from infection to presentation of 7-14 days and 14-21 days respectively. Approximately 90 percent of post-streptococcal glomerulonephritis occurs in young children. The diagnosis is made by supporting evidence of recent streptococcal infection, a positive ASO-titer or Anti-DNAase B titer, with associated hypocomplementemia. The disease is self-limited and generally requires only supportive therapy with resolution occurring over a period of weeks to months. There are generally no permanent sequelae in children. Adults may have a higher incidence of hypertension and chronic renal failure as a result of post-streptococcal glomerulonephritis.

Increased recombination adjacent to the Huntington disease-linked D4S10 marker

Huntington disease (HD) is caused by a genetic defect distal to the anonymous DNA marker D4S10 in the terminal cytogenetic subband of the short arm of chromosome 4 (4p16.3). The effort to identify new markers linked to HD has concentrated on the use of somatic cell hybrid panels that split 4p16.3 into proximal and distal portions. Here we report two new polymorphic markers in the proximal portion of 4p16.3, distal to D4S10. Both loci, D4S126 and D4S127, are defined by cosmids isolated from a library enriched for sequences in the 4pter-4p15.1 region. Physical mapping by pulsed-field gel electrophoresis places D4S126 200 kb telomeric to D4S10, while D4S127 is located near the more distal marker D4S95. Typing of a reference pedigree for D4S126 and D4S127 and for the recently described VNTR marker D4S125 has firmly placed these loci on the existing linkage map of 4p16.3. This genetic analysis has revealed that the region immediately distal to D4S10 shows a dramatically higher rate of recombination than would be expected based on its physical size. D4S10-D4S126-D4S125 span 3.5 cM, but only 300-400 kb of DNA. Consequently, this small region accounts for most of the reported genetic distance between D4S10 and HD. By contrast, it was not possible to connect D4S127 to D4S125 by physical mapping, although they are only 0.3 cM apart. A more detailed analysis of recombination sites within the immediate vicinity of D4S10 could potentially reveal the molecular basis for this phenomenon; however, it is clear that the rate of recombination is not continuously increased with progress toward the telomere of 4p.

Epidermal growth factor inhibits transiently the progression from G2-phase to mitosis: a receptor-mediated phenomenon in various cells

An immediate effect of epidermal growth factor (EGF) on the cell cycle is described. EGF, when given to replicating cells such as HeLa, A431, and D HER 14, very rapidly inhibits the transition from G2 phase to mitosis (M) in a transient fashion. The influence of EGF (10(-10) to 10(-7) M concentrations) on the G2-M transition of individual cells has been analyzed by time-lapse photography in cell lines carrying intact, mutated, or no EGF receptor. The G2-M transition of cells devoid of EGF receptor or carrying an EGF receptor devoid of most of the cytoplasmic domain was not influenced by EGF. In cells carrying intact EGF receptor, EGF caused a transient and dose-dependent delay in G2 phase which could last for greater than 2 h. Cells were inhibited in G2 within less than 10-20 min prior to prophase. A parasynchronous recovery from G2 inhibition was observed at large EGF concentrations; the G2-M transition rate exceeded that of the controls. The system described may represent a model for the mechanistic analysis of a ligand-induced transient restriction of the cell cycle, particularly at the G2-M border.

The role of the professional nurse in a bone marrow transplantation programme

Two different methods of transplantation are available. The allogeneic procedure is the transfer of bone marrow between compatible siblings, whereas in autografting the patient's own haematopoietic stem cells are collected, stored, and subsequently reinfused. Both forms have become established in the treatment of the leukaemias, aplastic anaemia, the malignant lymphomas, myeloma and certain immunologic diseases. Similarly, these techniques are being used in solid tumour oncology to reconstitute bone marrow function after high doses of chemotherapy, which would otherwise result in irreversible myelotoxicity. The success of such programmes depends upon a well developed multidisciplinary approach, prominently involving experienced and dedicated nursing staff. The latter individuals will establish contact with the patient typically during the first admission for chemotherapy and this will be consolidated during subsequent outpatient visits. Then follows the highly specialised care of central venous lines and management of radiation or chemotherapy-related side effects, often with intensive care needed for safe reversal of sepsis that may, however, be associated with renal or cardiorespiratory dysfunction. Most importantly, and again centrally involving the professional nurse, is responsibility for all aspects of maintaining and operating the protected environment, together with laminar air-flow rooms. Additional interaction is also necessary with dieticians, social workers, liaison psychiatrists, occupational therapists and frequently the infectious disease, cardiovascular, respiratory and renal services. Furthermore, achievement of optimal results presupposes the availability of a dedicated cell support section, as well as the competence to cryopreserve haematopoietic stem cells and monitor the safety of this step with in vitro bone marrow culture--another role for the specialised or academic nurse.(ABSTRACT TRUNCATED AT 250 WORDS)

The repeated sequence CATT(A/T) is required for granulocyte-macrophage colony-stimulating factor promoter activity

The hematopoietic growth factor GM-CSF (granulocyte-macrophage colony-stimulating factor) is expressed by activated but not resting T lymphocytes. Previously, we localized GM-CSF-inducible promoter activity to a 90-bp region of GM-CSF 5'-flanking sequences extending from bp -53 to +37. To more precisely identify the GM-CSF DNA sequences required for inducible promoter activity in T lymphocytes, we have performed mutagenesis within a region of GM-CSF 5'-flanking sequences (bp -57 to -24) that contains the repeated sequence CATT(A/T). Mutations that do not alter the repeated CATT(A/T) sequence do not eliminate inducible promoter activity, whereas mutation or deletion of either of the CATT(A/T) repeats eliminates all inducible promoter activity in T-cell lines and in primary human T lymphocytes. Thus, both copies of the direct repeat CATT(A/T) are required for mitogen-inducible expression of GM-CSF in T cells.

A novel oncofetal gene is expressed in a stage-specific manner in murine embryonic development

A novel cDNA clone obtained from a murine T-lymphoma library hybridizes to transcripts expressed in placenta and embryos (Pem) in a stage-specific manner. The Pem cDNA sequence predicts an intracellular hydrophilic protein with no significant sequence similarity to other DNA or protein sequences. Pem transcripts are abundant in 7- and 8-day mouse embryos, but decrease precipitously thereafter. On Day 9 they become abundant in placenta and yolk sac, persisting there until parturition. Although Pem transcripts are present in immortalized and tumorigenic cell lines from several different cell lineages, they are not detectable in any of 15 adult tissues tested. The expression of Pem during fetal development and its presence in immortalized and neoplastic cell lines is consistent with the properties expected of an "oncofetal" gene.

Disseminated zygomycosis and systemic lupus erythematosus

A young woman with long-standing systemic lupus erythematosus and rheumatic fever presented with deteriorating renal function. She had severe gastritis treated with cimetidine and received methylprednisolone when her blood cultures were repeatedly negative. She developed spontaneous bruising and bleeding from venepuncture sites, leading to clotting studies and a diagnosis of thrombotic thrombocytopenic purpura. At post-mortem, extensive evidence of disseminated zygomycosis was found. The likely portal of entry was the gastric route.

An outbreak of Acinetobacter respiratory tract infection resulting from incomplete disinfection of ventilatory equipment

An outbreak of multiresistant Acinetobacter anitratus respiratory tract infection occurred over a 30-day-period in six patients admitted to an intensive care unit. Standard precautions failed to curtail the outbreak, which was finally attributed to ineffective disinfection of reusable ventilator tubing.

Microbiology, chemotherapy and mortality of brain abscess in Newcastle-upon-Tyne between 1979 and 1988

71 patients admitted to Newcastle Regional Neurosurgical Centre between 1979 and 1988 with a diagnosis of brain abscess are reviewed. The overall mortality was 9.9%, with an operative mortality of 7%. The bacteriology of these abscesses is discussed in detail, together with the importance of effective standardized antimicrobial treatment regimens. The low mortality figures appeared to be in direct relationship to early recognition of this condition, prompt surgical intervention and effective chemotherapy.

Optical laboratory morphological inspection processor

Morphological transformations are applied to industrial inspection problems. A real time optical architecture to implement morphological transformations such as erosion, opening, closing, and skeletonization is described and analyzed. The first real time optical laboratory results of erosion and opening are presented for locating string in tobacco.