Vertical banded gastroplasty: operation for morbid obesity

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Studies of peritoneal macrophage function in murine systemic lupus erythematosus. 2. Nature of elevated resident peritoneal cells in NZB and (NZB x NZW)F1 mice

The numbers of resident peritoneal cells recovered from NZB and (NZB X NZW)F1 hybrid mice, which develop systemic lupus erythematosus (SLE), increased strikingly with age as compared with cells recovered from normal mice. The rise paralleled the onset of anti-DNA antibodies, occurring earlier in females than in males. The increased number of cells was due to an accumulation of medium-sized cells with an indeterminate appearance, but with the functional characteristics and cell markers typical of a macrophage. The unusual cells were esterase, F4/80 and Mac-1 positive, peroxidase, and Alcian blue negative, and were shown on sedimentation velocity separation to be phagocytic for EA and C3 (serum-treated) zymosan; 47-48% of peritoneal cells were Ia positive.

Reductions in coverage for mental and nervous illness in the Federal Employees Health Benefits Program, 1980-1984

After nearly 15 years of nondiscriminatory coverage, the largest plan in the Federal Employees Health Benefits Program cut its coverage of care for mental illness disproportionately to coverage for other health care in 1981 and 1982. "Catastrophic" coverage for inpatient mental illness care was introduced by many of the plans in 1984. The authors review the reductions in coverage from economic and clinical perspectives, highlighting the impact of the disparity between the coverage for mental illness and other medical conditions. The model of catastrophic protection for treatment of mental illness set forth in the Federal Employees Health Benefits Program does not bode well for the patient and family who must cope with such a financial contingency.

The heterogeneity and acceptor specificity of human serum galactosyltransferase

Human serum was fractionated by high resolution agarose isoelectricfocusing and the galactosyltransferase activity profile was determined using the ovalbumin, mucin, glucose and N-acetylglucosamine acceptor assays. The four acceptors gave very similar activity profiles. There were minor quantitative differences in some of the 12 or more peaks of activity detected and the only qualitative difference between them was a minor peak at pH 3.90 (2% of the total activity) which reacted only with the mucin acceptor. This suggests that most of the isoenzymes of human serum galactosyltransferase have broad and similar acceptor specificities and that the heterogeneity seen in serum cannot be accounted for by acceptor-specific forms of the enzyme.

Immunoregulation by macrophages. III. Prostaglandin E suppresses lymphocyte activation but not macrophage effector function during Salmonella enteritidis infection

Peritoneal macrophages obtained during primary or secondary infection with Salmonella enteritidis differ in the proportions of subpopulations with the capacity to secrete prostaglandin E (PGE) and interleukin 1 (IL1) and have bactericidal and tumoricidal activities in vitro. Using indomethacin in vivo and PGE in vitro we have studied the regulation of subpopulations of lymphocytes and macrophages by PGE during the inflammatory reaction. Indomethacin treatment promoted clearance of the Salmonella and a 50-90% increase in macrophages recovered from the peritoneal cavity in both primary and secondary infected animals. Whilst blocking the capacity of macrophages to secrete PGE in vitro the indomethacin treatment did not alter their bactericidal (or tumoricidal) activity nor their cyclic AMP response to PGE2. A major effect of indomethacin in vivo and of PGE2 in vitro however, was on the production and expression of IL1 and IL2. Secretion of IL1 by macrophages in vitro was greatly enhanced in indomethacin treated mice and was suppressed in vitro by PGE2. Prostaglandin E2 also inhibited IL1 dependent T-lymphocyte differentiation. IL2 secretion and IL2 dependent blast cell proliferation in vitro and sensitivity of the cells to PGE2 inhibition increased through this sequence of reactions. Lymphocyte populations harvested at intervals during primary or secondary infection differed in their cyclic AMP response to PGE2 and in IL2 secretion in vitro. This may be related to changes in the proportions of lymphocyte subsets having Lyt 1+ markers. We conclude that peritoneal macrophages from Salmonella infected mice differ in their capacity to secrete PGE and IL1.(ABSTRACT TRUNCATED AT 250 WORDS)

Structural characteristics of the macroeconomy and mental health: implications for primary prevention research

Recent research on the impact of economics on mental and physical health has raised fundamental questions about structural elements in the macro-economy. Specifically, five characteristics of our current economic system: instability in the business cycle, unemployment, inequality in income distribution, capital mobility, and fragmentation of the work process, appear to play some pathogenic role in the incidence of behavioral and physical disorders. These macroeconomic elements require intervention at the social policy level since they seem to be more powerful than the individual coping mechanisms of some demographic subgroups. Psychologists can play an important role in policy decisions by providing data on the relative impact of structural economic variables on human functioning. Examples of structural research are presented and the implications for primary prevention are discussed.

Epidural buprenorphine for pain relief after major abdominal surgery. A controlled comparison with epidural morphine

In a controlled trial epidural buprenorphine was compared with epidural morphine as the sole means of analgesia after major abdominal surgery. Bolus injections of buprenorphine 60 micrograms in 10 ml or morphine 2 mg in 10 ml of normal saline were given on demand for the first 48 hours postoperatively. Both drugs produced significant reduction in pain scores as assessed by the linear visual analogue scale and both produced prolonged analgesia at this dosage, which could be extended by further 'top-ups'. The authors conclude that, for postoperative epidural analgesia, buprenorphine may be the opiate of choice and the reasons for this are discussed.

The analysis of soluble galactosyltransferase isoenzyme patterns using high resolution agarose isoelectricfocusing

A high resolution method has been developed to separate the isoenzymes of galactosyltransferase by combining isoelectricfocusing (IEF) in 245 mm long agarose gels with a highly sensitive enzyme activity assay. The resolution and sensitivity is such that the isoenzyme pattern of 10 microliters human serum can be resolved. Using this method normal human serum was shown to contain at least 12 isoenzyme forms of galactosyltransferase, the major forms having isoelectric points of 4.33, 4.43, 4.51, 4.61, 4.74, 4.87, 4.96, 5.16 and 5.23. Part of the isoenzyme pattern complexity is due to sialylation of some isoenzymes. Alpha-lactalbumin-affinity chromatography, a method widely used in the purification of galactosyltransferase, causes a preferential purification of some of the isoenzyme forms.

Multiple Daily Amphetamine Administration: Behavioral and Neurochemical Alterations

In rats, multiple daily amphetamine injections (2.5 milligrams per kilogram of body weight, injected subcutaneously every 4 hours for 5 days) resulted in a progressive augmentation in response, characterized by a more rapid onset and an increased magnitude of stereotypy. By contrast, offset times of both the stereotypy and the poststereotypy hyperactivity periods were markedly shortened. When the animals were retested with the same dose of amphetamine 8 days after the long-term treatment was discontinued, the time of offset of the stereotypy and hyperactivity phases had recovered to values found with short-term amphetamine treatment, whereas the more rapid onset of stereotypy persisted. Brain monoamine and amphetamine concentrations and tyrosine hydroxylase activity were determined in comparably treated rats at times corresponding to the behavioral observations. The behavioral data indicate that enhanced responsiveness to amphetamine following its repeated administration may contribute to the development of amphetamine psychosis.

Multiple daily amphetamine administration: behavioral and neurochemical alterations

In rats, multiple daily amphetamine injections (2.5 milligrams per kilogram of body weight, injected subcutaneously every 4 hours for 5 days) resulted in a progressive augmentation in response, characterized by a more rapid onset and an increased magnitude of stereotypy. By contrast, offset times of both the stereotypy and the poststereotypy hyperactivity periods were markedly shortened. When the animals were retested with the same dose of amphetamine 8 days after the long-term treatment was discontinued, the time of offset of the stereotypy and hyperactivity phases had recovered to values found with short-term amphetamine treatment, whereas the more rapid onset of stereotypy persisted. Brain monoamine and amphetamine concentrations and tyrosine hydroxylase activity were determined in comparably treated rats at times corresponding to the behavioral observations. The behavioral data indicate that enhanced responsiveness to amphetamine following its repeated administration may contribute to the development of amphetamine psychosis.

Localization of a phaeochromocytoma situated in the pelvis by radionuclide scanning

Accurate localization of an extra-adrenal (pelvic) phaeochromocytoma was achieved by radionuclide scanning using 99 Tcm-Sn-DTPA. This facilitated the planning of the surgical approach and the subsequent removal of the tumour.