Hemorrhoids or rectal varices: defining the cause of massive rectal hemorrhage in patients with portal hypertension

Identifying the source of lower gastrointestinal hemorrhage in patients with chronic liver disease and portal hypertension can be challenging. We present 2 cases of hemorrhage from rectal varices and a discussion on the differences between simple hemorrhoids and rectal varices. Evaluation of rectal bleeding in patients with portal hypertension is discussed and possible therapeutic options are described.

Anaerobic degradation of veratrylglycerol-beta-guaiacyl ether and guaiacoxyacetic acid by mixed rumen bacteria

Veratrylglycerol-beta-guaiacyl ether (0.2 g/liter), a lignin model compound, was found to be degraded by mixed rumen bacteria in a yeast extract medium under strictly anaerobic conditions to the extent of 19% within 24 h. Guaiacoxyacetic acid, 2-(o-methoxyphenoxy)ethanol, vanillic acid, and vanillin were detected as degradation products of veratrylglycerol-beta-guaiacyl ether by thin-layer chromatography, gas chromatography, and gas chromatography-mass spectrometry. Guaiacoxyacetic acid (0.25 g/liter), when added into the medium as a substrate, was entirely degraded within 36 h, resulting in the formation of phenoxyacetic acid, guaiacol, and phenol. These results suggest that the beta-arylether bond, an important intermonomer linkage in lignin, can be cleaved completely by these rumen anaerobes.

Yeast mRNA initiation sites are determined primarily by specific sequences, not by the distance from the TATA element

We present evidence suggesting that accurate mRNA initiation in yeast cells, unlike their higher eukaryotic counterparts, is determined primarily by specific sequences downstream from the TATA element. First, changing the distance between the his3 TATA element and the initiation region does not affect the sites of initiation or the level of RNA. Second, reciprocal his3-ded1 and ded1-his3 hybrid promoters containing the upstream and TATA elements of one gene fused to the mRNA coding region of the other gene initiate transcription at sites defined by wild-type mRNA coding sequences, not by the distance from the TATA element. Third, when the his3 or ded1 promoter region is fused to position +2 of the his3 gene, transcripts initiated from a position equivalent to +1 are not observed. The results also suggest that the spacing between the TATA element and initiation site is relatively flexible; distance ranging from 40 to 90 bp appear to be functionally acceptable.

Degradation of Dehydrodivanillin by Anaerobic Bacteria from Cow Rumen Fluid

Dehydrodivanillin (DDV; 0.15 g/liter) was biodegradable at 37°C under strictly anaerobic conditions by microflora from cow rumen fluid to the extent of 25% within 2 days in a yeast extract medium. The anaerobes were acclimated on DDV for 2 weeks, leading to DDV-degrading microflora with rates of degradation eight times higher than those initially. Dehydrodivanillic acid and vanillic acid were detected in an ethylacetate extract of a DDV-enriched culture broth by thin-layer, gas, and high-performance liquid chromatographies and by mass spectrometry.

Ocular histopathologic and biochemical studies of the cerebrohepatorenal syndrome (Zellweger's syndrome) and its relationship to neonatal adrenoleukodystrophy

The eyes of three infants with cerebrohepatorenal disease (Zellweger's syndrome) who died demonstrated ganglion cell loss, gliosis of the nerve fiber layer and optic nerve, optic atrophy, and changes resembling those of retinitis pigmentosa in the retina and pigment epithelium. Ultrastructural examination showed bileaflet inclusions identical to those seen in neonatal adrenoleukodystrophy in the pigment epithelium and in pigmented macrophages, but these were absent in the cornea. Biochemical analysis of tissues demonstrated an excessive amount of very-long-chain fatty acids in the ocular tissues, an abnormality also found in adrenoleukodystrophy. These histopathologic and biochemical results demonstrated that the cerebrohepatorenal syndrome and neonatal adrenoleukodystrophy are similar in regard to ocular abnormalities and the presence of saturated very-long-chain fatty acids.

Retention of EMG biofeedback relaxation training

This study investigated how much subjects could retain ability to reduce muscle tension without daily practice and the extent to which periodic re-training would be a practical and effective way of retaining the skill. 19 male and 29 female subjects were given standard frontalis muscle biofeedback relaxation training. After initial training, 34 subjects in the experimental group were further randomly assigned to 3 different re-training groups: re-training once every 2 wk., re-training once every 4 wk., and none. All three groups maintained their ability to reduce muscle tension, and the group given re-training once every 2 wk. further improved that ability.

Coronary artery to left ventricle fistulas: echocardiographic features

The echocardiographic features of a coronary artery fistula that drains into the left ventricle were described in two patients. The clinical picture mimicked moderate to severe aortic insufficiency; however, M-mode echocardiogram revealed unusual features. Diastolic fluttering of the anterior mitral leaflet and the septum was absent in the first patient, while the second patient had marked diastolic fluttering of the posterior mitral leaflet and the left ventricular wall at the atrioventricular junction. In both, the coronary artery fistula could be visualized by cross-sectional echocardiography. Contrast echocardiography performed during cardiac catheterization in the second patient demonstrated that the diastolic fluttering of the posterior mitral leaflet was related to the jetting of blood from the coronary artery fistula.

Penicillin-sensitive Moraxella prosthetic endocarditis. Near disaster caused by failure to treat with penicillin

A patient with late prosthetic endocarditis resulting from Moraxella non-liquefaciens is reported. Correct laboratory indentification is of therapeutic importance as Moraxella is often highly sensitive to penicillin. Because of suspected penicillin sensitivity, antibiotics other than penicillin were used, but failed to control the endocarditis. Prompt response occurred when penicillin was given. Penicillin remains by far the most effective antibiotic for the treatment of endocarditis, particularly when affecting prosthetic valves, and caused by organisms sensitive to penicillin.

Comparison of sensory modes of biofeedback in relaxation training of frontalis muscle

The purpose of this study was to compare the effectiveness of various sensory modes of EMG biofeedback to relaxation training of the frontalis muscle. 19 male and 29 female subjects were randomly selected from a pool of college volunteers. They were then randomly assigned 12 each to audiofeedback, visual feedback, audiovisual feedback, and no feedback groups. There were 11 20-min. sessions per subject. Subjects in the biofeedback groups were trained to reduce muscle tension voluntarily by utilizing Cyborg J33 EMG portable trainers. The subjects in the three feedback groups exhibited significantly lower muscle tension than did the subjects in the no-feedback control group. There were no significant differences in relaxation among the three feedback groups.

Adrenoleukodystrophy: increased plasma content of saturated very long chain fatty acids

With a new method we measured the saturated very long chain fatty acids in the plasma of adrenoleukodystrophy (ALD) hemizygotes, ALD heterozygotes, and controls. ALD hemizygotes showed increased levels of hexacosanoate (C26 fatty acid) which represented 0.081 +/- 0.0066% (SEM) of total fatty acids, compared to 0.015 +/- 0.0032% in the controls. C25, C24, and C23 fatty acids were also increased, but the C22 and C20 fatty acids were normal. C26 levels were also increased in most ALD heterozygotes, with a mean level 0.057 +/- 0.0063% of total fatty acids. The technique can be used for diagnosis and carrier identification, and in the evaluation of therapy.

Use of genetic markers to certify fetal origin of cultured amniotic fluid cells

Phenotypes of five polymorphic enzymes: red cell acid phosphatase, phosphoglucomutase, esterase D, adenosine deaminase, and 6-phosphogluconate dehydrogenase were determined in extracts of 24 amniotic fluid cell cultures and in the corresponding maternal red cells. Twenty-one of the 24 fetus/mother pairs can be distinguished by at least one of the markers. Thus, polymorphic enzyme markers may be useful in affirmation of fetal origin of cultured cells and to avoid possible diagnostic errors.

Functional characterization of mouse lymphocyte subpopulations identified by their natural binding of bacteria. II. Identification of subpopulations of LY-1 + 2-3-, LY-1-2+3+ and LY-1+2+3+ cells and the localization of specific cytotoxic cells in a subset of LY-1-2+3+ cells

Three T-cell subpopulations (T1, T2 and T3) can be identified by their binding of various bacteria (Mayer, Chen, Dray & Teodorescu, 1978). In this work we determined how the three subpopulations identified by their Ly-1, -2 and -3 alloantigens were distributed among the T1, T2 and T3 subpopulations. We found that the T1 subpopulation contained most of the Ly-1+2+3+ cells, that the T2 subpopulation contained some Ly-1+2-3- and some Ly-1-2+3+ cells and that the T3 subpopulation contained the remainder of the Ly-1+2+3+, Ly-1+2-3- and Ly-1-2+3+ cells. Thus the subpopulations identified by their bacterial adherence properties subdivided the three subpopulations identified by their Ly-1, -2 and -3 alloantigens. We also investigated whether the specific cytotoxic T lymphocytes were contained in the T1, T2 and/or T3 cells. We found that essentially all of the cytotoxic T lymphocytes were contained in the T3 subpopulation. Since the T3 cells contained a subpopulation of Ly-1-2+3+ cells the data indicated that essentially all of the cytotoxic T lymphocytes were contained in a subpopulation of Ly-1-2+3+ cells.

A case of malignant lymphoma, undifferentiated, Burkitt's type with high antibodies to Epstein-Barr virus

A 5-year-4-month-old girl was admitted to Taipei Municipal Jen-Ai Hospital because of a rapidly enlarging right submandibular tumor. The diagnosis of malignant lymphoma, undifferentiated, Burkitt's type was made by distinctive histopathological features. Positive serological findings related to Epstein-Barr virus infection were disclosed. Complete remission has been achieved since the treatment with high-dose cyclophosphamide was given, and no signs of relapse have been found yet.

A mouse model of pneumonitis induced by Chlamydia trachomatis: morphologic, microbiologic, and immunologic studies

Swiss-Webster white mice were infected with Chlamydia trachomatis organisms through intranasal inoculation. It was found that a typical interstitial pneumonitis could be induced. Histopathologic findings showed that the lung infiltration was predominantly polymorphonuclear cells and was most prominant on Day 2. The cellular infiltrate gradually changed to mononuclear cells after Day 3. Intracytoplasmic inclusions were frequently found in the interstitial cells and occasionally in the bronchial epithelial cells. Typical chlamydial bodies (elementary, intermediate, and reticulate forms) were identified by electron microscopy. The organisms were recovered from mouse lungs on Days 1--7, with the highest yields on Day 2. This correlated with the peak of lung infiltration seen by histologic examination. Antibodies specific to the infecting immunotype began to appear between Day 7 and Day 10 after inoculation and lasted until Day 35 without a decline in titers. A delayed hypersensitivity reaction was observed by footpad test from Day 5 to Day 21, with the peak reaction at Day 7. This study showed that the mouse model could be used to study the immunopathogenesis of C trachomatis infection.

The effect of a body burden of methylmercury on hepatic regeneration

The model of hepatic regeneration is chosen to study the effect of methylmercury burden on cell proliferation. The results show that chronic methylmercury burden impedes the rate of thymidine incorporation during the process of DNA synthesis. At 24 hours after partial hepatectomy, thymidine incorporation in the mercury exposed rats is 53% of the controls. Counts of labeled hepatocytes in radioautographic preparations also support this observation. This remarkable difference in DNA synthetic activity at 24 hours also reflects in the DNA content and liver, weights at 72 hours after partial hepatectomy (Liver weights 2.36 +/- 0.21 gm/100 gm B. W. vs. 2.67 +/- 0.31 gm/100 B. W., P < 0,05; DNA contents 160.78 +/- 36.76 microgram/gm vs. 214.80 +/- 37.908 microgram/gm, P < 0.05). After two weeks, no significant difference is noted in liver weight, DNA content and synthetic activity. On the other hand, protein content and biosynthesis in the liver of methylmercury burdened rats shows no significant difference from the controls in all the periods studied. From these data it is concluded that the dividing fraction of hepatocytes is reduced in methylmercury-treated group at an early stage of regeneration when cell proliferation is most active.

Mechanisms of prolongation of pre-ejection period in patients with left ventricular disease

In order to determine the mechanism underlying prolongation of the pre-ejection period in patients with left ventricular disease, 11 patients with congestive cardiomyopathy and 29 with coronary artery disease, 10 of whom were taking beta-adrenergic blocking drugs, were studied non-invasively. Recordings of carotid pulse, and apex, phono-, and echocardiogram were obtained. In the absence of treatment with beta-blocking drugs, prolongation of pre-ejection period correlated closely with incoordinate left ventricular wall movement during isovolumic contraction assessed from simultaneous apex and echocardiograms. There was no correlation between pre-ejection period index (PEPI) and end-diastolic dimension and PEPI correlated poorly with fractional shortening and peak Vcf. A PEPI of greater than 140 ms was associated with incoordinate contraction in all but one case, and of less than 140 ms with normal contraction in all. Therapeutic doses of beta-blocking drugs caused prolongation of PEPI to a greater extent than would have been predicted from wall movement during isovolumic contraction. Incoordinate left ventricular contraction and a negative inotropic effect both therefore prolong PEPI, but by different mechanisms, whose effects can be separated in individual patients using non-invasive methods based on echocardiography.

The effect of methylmercury on isolated cardiac tissues

The effect of methylmercury hydroxide (MMH) on the frequency of spontaneously beating atrial-SA node and on the isometric tension of electrically stimulated left atrial (1 Hz) preparation isolated from rats were investigated. The tissues were also fixed for ultrastructural study at the end of the experiments. We found that MMH, at low doses (0.5 and 2ppm), increased the frequency of contractions and the isometric tension of isolated atria and decreased the isometric tension of isolated papillar muscles, and at higher doses (greater than 2ppm), decreased all the above parameter. Morphologically, there were dilation and swelling of mitochondrial and sarcoplasmic reticulum. Occasionally, deposits of amorphous material in the mitochondria and myofibrillary degeneration of myocardial fibers were noted. It is concluded the MMH has direct effect on intracellular organelles (mitochondria, sarcoplasmic reticulum, and myofibril) of myocardial tissue and induces functional changes of atria and papillary muscles

Interaction of delta-chymotrypsin with proflavine

A 1:1 molar stoichiometry has been found for the noncovalent bonding of proflavine with δ-chymotrypsin. The dissociation constant at pH 7.6 is 0.025 mM which is similar to that found by Glazer for the reaction of proflavine with α-chymotrypsin. The difference spectrum produced by the proflavine–δ-chymotrypsin interaction has been studied as a function of pH. It would appear that a group with pK of approximately 6.5 is involved.

Radioimmunoassay of follicle-stimulating (FSH) and luteinizing (LH) hormones by chromatoelectrophoresis

Procedure for the radioimmunoassay of FSH and LH using chromatoelectrophoresis for the separation of antibody-bound and free labeled hormone is described. Diurnal variation in FSH and LH levels of normal men and women in follicular and luteal phases of the cycle is reported. The diurnal variation was not abolished in three women taking contraceptive medication and in two women in postmenopause. The diurnal variation of FSH and LH in plasma is compared with that of cortisol, dehydroepiandrosterone and testosterone. It is suggested that diurnal variation of FSH and LH may be independent of a normally functioning pituitary-gonadal axis; however, steroidal feed-back may have a regulatory effect on the magnitude of the diurnal variation. The plasma levels of FSH and LH in normal subjects during normal menstrual cycles as well as in patients with endocrinopathies obtained in our laboratory by radioimmunoassay are compared with those obtained by both radioimmunoassay and bioassay by other investigators.