Clinical evaluation of Purilens, an ultraviolet light contact lens care system

Purilens is a new contact lens care system that uses ultraviolet light and subsonic turbulence for lens cleaning and disinfection. In a single hands-off process using only preservative-free sterile saline, the lenses are ready to wear after a 15-minute cycle. This study was designed to test the safety of this contact lens care system. A total of 84 contact lens wearers from six centers were enrolled in the 3-month study, which comprised an initial visit and follow-up visits at 1, 2, 4, 8, and 12 weeks. At the end of the study, lenses and units were collected and a questionnaire was completed. Seventy-six of the 84 subjects (168 eyes) completed the study. No severe eye complications were reported, and no patients were removed from the study because of ocular problems or complications associated with the device or its use. Four patients were removed from the study for noncompliance with follow-up. Another four patients were active for 2 months, but were requested by the sponsor to complete the study 1 month early to complete data collection. Patient satisfaction was high. The study suggests that Purilens may be considered as an alternative for contact lens cleaning and disinfection.

Responses to repeated days of light work at moderate temperatures in protective clothing

This study assessed workers' ability to sustain work output over four consecutive workdays in encapsulating protective clothing (PC). Six subjects wearing a two-piece PC ensemble cycled at a work rate of 38 W in a 29/22 degrees C (dry/wet bulb) ambient temperature. Work continued until rectal temperature (Tre) reached 38.3 degrees C, or volitional fatigue. Subjects then rested without PC in a 21 degrees C room until Tre reached 38.0 degrees C to simulate micro- or macro-environmental cooling during rest. Work was alternated with rest for four hours total. Contrary to expectations, mean work time did not diminish on succeeding days. Subject responses to the repeated exposures was highly variable and in no case changed significantly (p > .05) from day one to day four. Subjects tolerated well repeated four-hour exposures with controlled elevations in Tre. There was no clear evidence of either increased or decreased tolerance of this work-rest paradigm across days.

An on-line analysis of syntactic processing in Broca's and Wernicke's aphasia

This paper is about syntactic processing in aphasia. Specifically, we present data concerning the ability of Broca's and Wernicke's aphasic patients to link moved constituents and empty elements in real time. We show that Wernicke's aphasic patients carry out this syntactic analysis in a normal fashion, but that Broca's aphasic patients do not. We discuss these data in the context of some current grammar-based theories of comprehension limitations in aphasia and in terms of the different functional commitments of the brain regions implicated in Broca's and Wernicke's aphasia, respectively.

Too soon to panic

Health Care: The small-business lobby says Clinton's mandatory plan will kill off jobs. But Mom and Pop may end up breathing easier.

The influence of physical fitness on automatic and effortful memory changes in aging

A cross-sectional study was carried out in order to determine the influence of cardiovascular fitness on age-related declines in cognitive performance. Forty-eight volunteers were divided into Young (n = 13, 18-27 years), Middle-Aged (n = 22, 60-65 years) and Old (n = 13, 65-88 years) groups and tested on a battery of cardiovascular, pulmonary, hemodynamic, and biochemical tests in order to assess physical fitness. Cognitive performance was evaluated by a variety of memory tasks distributed along an automatic-to-effortful processing continuum. Memory for location and frequency of occurrence were selected as representative of automatic processing, whereas, an auditory free-recall task was selected as representative of effortful processing. Age-related performance declines were observed for the free-recall task, but no such age-dependent association was observed for frequency and location memory. With regard to the influence of physical fitness; the Middle-Aged and Older participants were divided into High and Low Fitness groups and significant differences were observed between these groups for the effortful but not the automatic memory tasks. These data suggest that the relationship between physical fitness and cognitive performance in old age is task dependent. Furthermore, the apparent prophylactic effects of physical fitness on effortful memory, do not appear to extend to cognitive tasks requiring less effortful processing.

The consequences of expressing hsp70 in Drosophila cells at normal temperatures

In Drosophila cells, regulatory mechanisms not only act to provide rapid induction of hsp70 during heat shock but also to prevent expression at normal temperatures. To determine whether expression of hsp70 is detrimental to cells growing at normal temperatures, we used heterologous promoters to force expression of the protein in tissue culture cells and in larval salivary glands. Initially, constitutive expression of hsp70 substantially reduces the rate of cell growth. With continued expression, however, growth rates recover. At the same time, the intracellular distribution of hsp70 changes. Immediately after induction, the protein is diffusely distributed throughout the cell, but as growth resumes it coalesces into discrete points of high concentration, which we term hsp70 granules. hsp70 granules are also observed both in wild-type Drosophila tissue culture cells and in salivary glands after extended periods of recovery from heat shock. The protein in these granules appears to be irreversibly inactivated. It cannot be dispersed with a second heat shock, and cells containing these granules do not show thermotolerance. Only partial overlap between hsp70 granules and lysosomes indicates that the granules form independently of lysosomes. We conclude that expression of hsp70 is detrimental to growth at normal temperatures. We suggest that the change in hsp70 distribution, from diffuse to granular, represents a mechanism for controlling the protein's activity by sequestration.

Percutaneous urinary diversion in gynecologic oncology

During the 10-year period after 1979, percutaneous urinary diversion (PCUD) was performed on 35 patients whose mean age was 53.5 years (30-80 years). Twenty-one patients (60%) had Stage IIB-IV cervical cancer, 11 (31%) Stage IB-IIA cervical cancer, 2 (6%) Stage IB-II endometrial cancer, and 1 (3%) Stage IB vaginal cancer. All had radiological evidence of ureteric obstruction and 8 patients also had urinary tract fistulae. Serum creatinine levels were elevated in 24. Following diversion there was a significant fall in mean pretreatment creatinine levels from 482 mumol/liter (range, 70-1703 mumol/liter) to 131 mumol/liter (range, 60-290 mumol/liter; P less than 0.0001); those patients with normal creatinine levels prior to diversion also had a reduction in their levels. A significant fall in mean serum urea levels from 22.0 mmol/liter pre- to 11.9 mmol/liter post-PCUD (P less than 0.001) was also noted. Minor complications occurred and included hemorrhage, replacement/reinsertion, infection, and blockage. Median survival of the 35 patients after PCUD was 6 months (mean, 16.5 months). For the 11 with normal pretreatment renal function median survival was 16 months (mean, 41 months) compared to 2.5 months (mean, 5.1 months) for those with elevated pretreatment serum creatinine levels. Median survival with untreated malignancy was 7 months (mean, 19.6 months) and 6 months (mean, 12.3 months) in patients with previously treated cancer. PCUD is indicated in previously untreated patients with gynecologic cancer so that primary therapy can be instituted. The role of urinary diversion in patients with previously treated cancer must be individualized. Palliative diversion is appropriate in selected patients where additional therapy is expected to prolong life, where symptom control is needed, or to allow the patient to return home for a significant proportion of the remainder of life.

Physical assessment skills in undergraduate curricula

A survey of nursing educators reveals that physical assessment skills are now accepted as basic to the nursing process. But though they agree on what to teach, nursing educators do not agree on when to teach it: sophomore, junior, or senior level?

Diversity of oligosaccharide structures on the envelope glycoprotein gp 120 of human immunodeficiency virus 1 from the lymphoblastoid cell line H9. Presence of complex-type oligosaccharides with bisecting N-acetylglucosamine residues

The N-linked oligosaccharide structures on the envelope glycoprotein gp120 of human immunodeficiency virus 1 derived from chronically infected lymphoblastoid (H9) cells have been investigated by enzymatic microsequencing after release from protein by hydrazinolysis, labeling with NaB3H4, and chromatography on adsorbent columns of Phaseolus vulgaris erythrophytohemagglutinin and Ricinus communis agglutinin (Mr 120,000) and on Bio-Gel P-4. A substantially greater diversity of oligosaccharide structures was detected than among those released by hydrazinolysis from recombinant gp120 produced in Chinese hamster ovary cells and investigated by similar procedures (Mizuochi, T., Spellman, M.W., Larkin, M., Solomon, J., Basa, L.J., and Feizi, T. (1988) Biochem J. 254, 599-603) and among those released by endoglycosidases from virus-derived gp120 isolated from infected H9 cells after metabolic labeling with D-[2-3H]mannose or D-[6-3H]glucosamine (Geyer, H., Holschbach, L., Hunsmann, G., and Schneider, J. (1988) J. Biol. Chem. 263, 11760-11767). In this study, 16% of the oligosaccharides were identified as complex-type bi-, tri-, and tetraantennary sialo-oligosaccharides with bisecting N-acetylglucosamine residues. Such structures were lacking on recombinant gp120 and could not be detected on the metabolically labeled, virus-derived glycoprotein. As in the earlier investigations, complex-type chains lacking bisecting N-acetylglucosamine residues, hybrid-type chains, and a series of high mannose-type structures with 5-9 mannose residues were identified. In addition, an array of complex-type chains having one or more outer chains with beta-galactosyl residues were detected in this study, but with additional substitutions that require further investigation. The number of potential N-glycosylation sites on gp120 is on the order of 20, but the oligosaccharide structures are far more numerous. Thus, the salient conclusion from this and earlier investigations is that alternative structures occur on at least some of the glycosylation sites and that numerous glycosylation variants of this glycoprotein are produced even within a single cell line. Since the glycosylation is the product of host cell glycosyltransferases, an even greater number of glycosylation variants of gp120 are predicted to arise from the heterogeneous cell populations harboring the virus in in vivo infection.

The development of an enzyme-linked immunosorbent assay for measuring the potency of vaccines containing Clostridium chauvoei antigens

Current standards (British Pharmacopeia (Veterinary) 1985) for vaccines containing Clostridium chauvoei require a potency test based on a challenge assay in guinea-pigs. Animal welfare and cost considerations favour the development of alternatives. Most veterinary clostridial vaccines are multi component, requiring assays in rabbits to test the potency of components other than C. chauvoei. We describe the application of an ELISA to measure the response to C. chauvoei vaccines in rabbits. The antigen is a sonicated extract of C. chauvoei strain CH4, intended to include a mixture of cellular and soluble antigens. The rabbit response to more than 70 vaccines containing C. chauvoei has been assessed against a reference serum which has been assigned an arbitrary potency of 100 units ml-1. The antibody titres of rabbit sera have been compared with the results of guinea-pig challenge potency tests on the same vaccines. The pass level in the guinea-pig potency test is equivalent to a rabbit ELISA titre of 50 units ml-1.

A comparative study of proliferating (borderline) and invasive epithelial ovarian tumours in young women

A series of 18 patients with proliferating or borderline ovarian tumours and 18 with invasive ovarian tumours is discussed. Proliferating tumours occurred at a younger mean age than invasive disease, and presented at an earlier stage, both contributing factors to their more favourable outlook. Histopathological assessment revealed that the majority of both proliferating and invasive tumours were of serous origin. Mucinous cell type occurred less often as did the endometrioid and clear cell types. The management of the proliferating tumours involved 'radical' surgical procedures in 11 of 18 (61.6%) patients. Only 7 patients (38.8%) had conservative surgical procedures performed. Six patients (33%) had adjuvant chemotherapy while 2 (11%) also underwent abdominopelvic irradiation. All patients with invasive disease had radical surgery and adjuvant chemotherapy and 2 also received abdominopelvic irradiation. The fact that epithelial malignancies of the ovary do occur in younger women needs to be remembered by gynaecologists contemplating surgical procedures on younger patients with adnexal masses. Proliferating or borderline tumours tend to occur more frequently in the younger age groups, and contrary to the implication of their name, they are associated with significant morbidity and mortality.