Reversal of postoperative immunosuppression in man by vitamin A

The effects of therapy with vitamin A on immune responsiveness after extensive surgical treatment were studied in vitro. Postoperatively, in control patients, there was depression of the total lymphocyte count and the response in the mixed lymphocyte reaction to a pool of stimulating cells. Treatment with pharmacologic dosages of vitamin A prevented depression of these parameters in the postoperative period. The mitogenic response to phytohemagglutinin and monocyte mediated hemolysis was not consistently altered by operation in control patients, but there was a trend toward increased activity in those receiving vitamin A. Thus, vitamin A appears to be an immunostimulant in man.

Diurnal variation in the quality and outcome of newborn intensive care

Variables related to both the process and the outcome of neonatal intensive care were studied to compare care given during the day (0901-2100 hours) with that at night (2101-0900 hours). At night, intravenous infiltrations occurred more often, and the tidal volume of respirator-treated infants was verified less often. Blood pH values less than 7.20, excluding values within 12 hours of admission, were recorded more often and in more patients at night. During a 12-month period, there were significantly more deaths among infants less than 1,500 gm during the night than during the day. The deterioration of infants at night may result in part from current nursery staffing practices.

The use of affinity chromatography in purification of cyclic nucleotide receptor proteins

Biospecific affinity chromatography has been used to purify specific cyclic AMP and cyclic GMP receptor proteins. Several variables are important for successful purification of the cyclic AMP receptor protein, the most critical being the length of the aliphatic spacer side arm. 8-(2-Aminoethyl)-amino-cyclic AMP coupled to the aliphatic spacer side arm. 8-(2-Aminoethyl)-amino-cyclic AMP coupled to agarose specifically retains the cyclic AMP receptor protein by interaction with the immobilized nucleotide. Binding of the cyclic AMP receptor subunit of cyclic AMP-dependent protein kinase to the immobilized nucleotide results in dissociation of the catalytic protein phosphokinase subunit which is not retained. The retained cyclic AMP receptor protein is subsequently eluted by cyclic AMP. Homogeneous cyclic AMP receptor protein prepared from rabbit skeletal muscle by affinity chromatography has been characterized. The molecular weight of the native protein as determined by analytical ultracentrifugation and polyacrylamide gel electrophoresis at varying acrylamide concentrations is 76 800 and 82 000, respectively. The protein is asymmetric with frictional and axial ratios of 1.64 and 12. SDS and urea polyacrylamide gel electrophoresis indicate that the native cyclic AMP receptor is composed of two identical subunits of 42 700 molecular weight. The native protein dimer binds 2 moles of cyclic AMP per mole of protein and is active in suppressing activity of isolated catalytic subunits of cyclic AMP-dependent protein kinase. Cyclic GMP receptor protein from bovine lung has been purified using the same affinity chromatography media. Since cyclic nucleotide binding to cyclic GMP-dependent protein kinase does not result in dissociation of regulatory receptor and catalytic phosphotransferase subunits, the cyclic GMP-dependent protein kinase holoenzyme is retained on the column and can be subsequently specifically eluted with cyclic GMP.

Urinary tract changes in obstetric vesico-vaginal fistulae: a report of 216 cases studied by intravenous urography

Intravenous urographies carried out routinely on 216 cases of vesico-vaginal fistulae were reviewed. All the patients had suffered from urinary incontinence following obstructed labour for periods varying from immediate post-partum period to as long as 35 years with the majority (48%) presenting in the first year of the disease. One hundred and eleven patients (51-4%) showed no urinary tract abnormality. Calyceal abnormality was graded from 1-5 in ascending order of severity. The most frequent abnormality was Grade 1 (or minimal calyceal blunting) found in 75 (71%) of 105 cases showing lesions. Ten patients had non-functioning kidneys. There was no correlation of severity of calyceal grading with duration of the disease. Other notable changes were hydroureter in 75 (34%), medial deviation of the terminal ureters in 21 (9-7%) and bladder calculi in four. The study reveals a high risk of morbidity to the kidneys in patients with vesico-vaginal fistulae and the predominant role of fibrous itssue in tis genesis is postulated.

Intracranial and extracranial nasopharyngeal angiofibroma. A surgical approach

Two patients with juvenile nasopharyngeal angiofibromas with known or suspected intracranial extension were treated successfully with a surgical procedure. The procedure involves careful preoperative examination with four-vessel carotid angiography followed by preoperative occlusion of the extracranial major feeding vessels. This is followed by craniotomy, direct control of all intracranial feeding vessels, and then total extirpation of the tumor.

Abnormal microorganisms and cell-mediated immunity in patients with intraoral cancer

A substantial number of patients with intraoral malignant neoplasms have abnormal bacterial flora of skin, nasopharynx, and oropharynx, without a demonstrable relationship between tumor size, location, or degree of ulceration. Seventeen consecutive patients were studied to determine what relationship, if any, exists between the presence of abnormal microorganisms and the patients' immunological competence. Ten of 17 patients grew potentially pathogenic organisms, and all reacted to specific skin tests used to infer immunological competence. Thus, there appeared to be no relationship between cellular immunity and the presence of abnormal bacteria in patients with intraoral malignant neoplasms.

Adenotonsillectomy in a Jehovah's Witness with blood dyscrasia

A case is used to illustrate a method of management of three unusual problems all simultaneously appearing in the same patient. Urgent surgical intervention was necessary for a child with a bleeding disorder, but the parents religious doctrine prohibited the use of whole blood or its products. The combined efforts of the legal, medical, and allied medical professionals led to a successful resolution of the patient's multiple problems.

Prevention of galactosamine-induced liver cell necrosis by uridine

The administration of galactosamine to rats produces dose-dependent liver cell injury. A relatively low dose of galactosamine (200 mg/kg) causes a marked fall in UTP with an accompanying inhibition of RNA and protein synthesis. Uridine will reverse the UTP deficiency and the inhibition of RNA and protein synthesis at any time. The administration of a larger dose of galactosamine (400 mg/kg) produces liver cell necrosis within 12 hours. Although the effects on macromolecular synthesis are very similar with the two doses, cell necrosis distinguishes the reaction of the liver to the larger dose from that to the lower. Uridine will also prevent the development of liver cell necrosis, even if given as late as 3 hours after the galactosamine. This was shown by examination of the changes in serum glutamic oxalocetic transaminase levels and by examination of the histologic changes in the livers. Other purines do not have this protective effect; adenine is unable to prevent liver cell necrosis. As the known biochemical effects of the two doses of galactosamine are very similar during the first 3 hours, the protective effect of uridine seems to imply the existence of an as yet unknown lesion distinguishing the reaction of the liver cell to the larger dose of galactosamine. Uridine must prevent the appearance of this lesion or reverse its development.