Margins drop in first quarter as admissions decline sharply

The recession has had a significant impact on hospital utilization, finances and staffing; all are lower than a year ago, according to the American Hospital Association. Among the worrisome benchmarks: a sharp decline in inpatient admissions in the first quarter.

Temperature-induced protein synthesis in Bacillus stearothermophilus NUB36

Cultures of Bacillus stearothermophilus subjected to a temperature shift-up or shift-down of 15 degrees C within the normal temperature range of growth (45 to 65 degrees C) enter a transient adaptation period before exponential growth at the new temperature. The de novo synthesis of some proteins coincides with the adaptation period.

[A long-term follow-up of 29 cases of benign epilepsy in childhood with central-temporal electroencephalographic foci]

29 cases of benign epilepsy in childhood with central-temporal EEG foci (BECCT) were followed up from 2 to 9 years clinically and electro encephalographically. Focal discharges in several cases were found to be changeable from one cerebral hemisphere to another. The subsidence of clinical seizures usually preceded epileptic discharges. Such focal discharges often disappeared before puberty whereas the clinical seizures would not manifest themselves even earlier. Small doses of antiepileptic drugs were effective for the majority of such patients. One patient with occasional seizures but without medication had been observed.

Cloning and characterization of a glutamine transport operon of Bacillus stearothermophilus NUB36: effect of temperature on regulation of transcription

We cloned and sequenced a fragment of the Bacillus stearothermophilus NUB36 chromosome that contains two open reading frames (ORFs) whose products were detected only in cells of cultures grown in complex medium at high temperature. The nucleotide sequence of the two ORFs exhibited significant identity to the sequence of the glnQ and glnH loci of the glutamine transport system in enteric bacteria. In addition, growth response to glutamine, sensitivity to the toxic glutamine analog gamma-L-glutamylhydrazide, and glutamine transport assays with parental strain NUB3621 and mutant strain NUB36500, in which the ORF1 coding segment in the chromosome was interrupted with the cat gene, demonstrated that glnQ and glnH encode proteins that are active in the glutamine transport system in B. stearothermophilus. The inferred promoter for the glnQH operon exhibited a low homology to the -35 and -10 regions of the consensus promoter sequences of Bacillus subtilis and Escherichia coli genes. In addition, the inferred promoter for the glnQH operon also exhibited a low homology with the consensus promoter sequence deduced from the sequences of the promoters of nine different genes from B. stearothermophilus. Transcription of the glnQH operon was activated in a nitrogen-rich medium at high temperature and inhibited under the same conditions at low temperature. Transcription of the glnQH operon was partially activated in a nitrogen-poor medium at low temperature. The region upstream from glnQ contains sequences that have a low homology with the nitrogen regulator I-binding sequences and the nitrogen-regulated promoters of enteric bacteria. The effect of temperature on the regulation of the glnQH operon is discussed.

[The color vision in patients with optic neuritis and chronic open-angle glaucoma]

Twenty eight cases (50 eyes) of chronic open-angle glaucoma and 21 cases (27 eyes) of optic neuritis were investigated with FM 100-hue test and panel D-15 test. In patients with optic neuritis, 70.37% and 85.19% of the affected eyes appeared abnormal in Panel D-15 test and FM 100-hue test respectively. The main defects were tritan-like in both of the tests. In patients with chronic open-angle glaucoma, 20% and 32% of the affected eyes had abnormal results in Panel D-15 test and FM 100-hue test respectively. The main defects were also tritan-like color vision defect. The total error scores of FM 100-hue test in patients with chronic open-angle glaucoma had no relation with the cup disc ratio and the area of peripheral visual field but had relation with the area of central visual field.

[Visual rehabilitation in low vision patients with aging macular degeneration]

Using optical visual aids, visual rehabilitation were performed in 14 cases (25 eye) of low vision patients with aging macular unity of all eyes (100%) was improved. Thirteen eyes (52%) got the near vision equal to or better than 0.5. Ten patients could read No. 5 Chinese Reading Card. The reading success rate was 71.4%. The results suggest that application of visual aids is an effective method to improve the distance and near visual acuity of low vision patients with AMD.

The frequency and significance of ECG changes after transurethral prostate resection

Although many clinicians routinely recommend a base-line preoperative electrocardiogram (ECG) and obtain frequent postoperative ECGs to screen for myocardial infarction or ischemia, the diagnostic utility of screening perioperative ECGs is unknown. The present analysis evaluates the sensitivity and specificity of the perioperative ECG and examines its value as a predictor of early postoperative cardiac events and outcomes during the postoperative year. ECGs obtained preoperatively and on the first 3 postoperative days in 206 men undergoing transurethral prostate resection were analyzed using the Minnesota Code. The occurrence of cardiac events during the operative stay was assessed by measurement of the cardiospecific MB creatine kinase isoenzyme on the first 3 postoperative days and review of the entire clinical course. Twenty-one percent of patients developed postoperative ECG changes, mostly involving the T wave; none had cardiac symptoms or sustained creatine kinase MB elevation. Changes were not significantly more common in men known to have coronary disease. The single patient who had a perioperative myocardial infarction confirmed by enzymes had no codable ECG changes. The specificity of any ECG change for perioperative infarction was 78%; of ST segment changes only, 95%. Only one of the patients (2%) who had postoperative ECG changes had a cardiac event in the year after surgery. Routine perioperative ECGs is of little diagnostic/predictive utility in situations in which the incidence of perioperative myocardial infarction is low.

Hospitals end 1990 with negative net patient margin in aggregate

The economic outlook for hospitals clouded over considerably in 1990, according to the latest report from the American Hospital Association. By year end, according to the AHA's National Hospital Panel Survey, hospitals ended with a negative net patient revenue margin, influenced strongly by lower admissions and higher inflation. An increase in total expenses may also be related to the expansion of outpatient services and continuing growth in health care employment.

[Bulbar conjunctival microcirculation in schizophrenics]

A comparative observation on bulbar conjunctival microcirculation (BCM) between 38 schizophrenics and 38 normal controls was carried out. The results showed 95% abnormal BCM in schizophrenics. And among them, the moderate and severe abnormal BCM was 74%. And in all of the 14 investigated items, the general abnormalities were 50%. But in normal controls, abnormal BCM was 27%, and just a few of them appeared the general abnormalities, and no one suggested moderate and severe abnormal BCM. As compared the results obtained in schizophrenics with those in normal controls, we found 12 investigated items such as irregularity in diameter, dilatation and tortuosity of tiny vena; irregularity in diameter, stiff of tiny arteria; small hemorrhagic spot, brown pigmentation, red blood cells collected in tiny vena and capillary, small vascular density, speed of blood flow and arterio-venous ratio were statistically significant.

The effect of genetic determinants of low density lipoprotein levels on lipoprotein (a)

Levels of Lipoprotein(a) [Lp(a)] correlate directly with atherosclerosis risk. The Lp(a) particle is physically and chemically similar to low density lipoprotein (LDL), the main difference being the presence of apolipoprotein(a) [apo(a)] bonded to the apoB-100 moiety of LDL. Genetic variation of apo(a) primarily determines Lp(a) phenotype. However, other genetic factors may also have a role in determining Lp(a) levels. Large families provide a unique opportunity to evaluate the contribution of genetic factors to disease. In several large Utah kindreds with various genetic abnormalities of lipoprotein metabolism we determined that: 1) Lp(a) levels are associated with defects at the apoB gene; 2) Lp(a) levels are not associated with defects at the LDL-receptor gene; 3) high density lipoprotein (HDL) levels are associated with genetic variation at the apo(a) locus; and 4) the DNA sequence of the apoB-100 binding domain does not vary between siblings with high and low Lp(a) levels.

The significance of testing preoperative visual function in cataract using laser interferometric visual acuity and ERG

Tests of preoperative visual function and prediction of postoperative E chart visual acuity (ECVA) using laser interferometric visual acuity (LIVA) and electroretinogram (ERG) were performed in 16 cases (19 eyes) of cataract. The results showed that the coincident rate between preoperative LIVA and postoperative ECVA was 63.2%, and there was a parallel correlation between preoperative amplitude of photopic ERG b-wave and postoperative ECVA in 79.0% of the eyes. Comparing these two methods, the test of LIVA is very simple, fast, and is easily accepted by the patients with cataract. ERG is an objective method, which is slightly influenced by dense lens, but the test is more complex. Therefore, the combined use of these two methods will provide a more comprehensive and correct evaluation of preoperative visual function and a more reliable prediction for postoperative visual acuity in patients with cataract.

[Effects of microinjection of tutin into nucleus tractus solitarius region on the morphology of neural tissue of this area in rabbit]

Four hours after unilateral microinjection of tutin (10 micrograms) into the NTS region, the nervous tissue surrounding the center of microinjection showed the following morphologic changes: 1. Under the light microscopic examination (n = 5), the neuronal body showed chromatolysis and the nuclear basophilia enhanced in about 17% of the neurons, the lacunae of neuropil distended and gave a "spongy" appearance. The neurons with lesion mingled with the normal ones in the absence of distinct demarcation. 2. Under the electron microscopic examination (n = 3), the cisterns of rough endoplasmic reticulum distended, and the nuclear electron density increased on account of the increased nuclear chromatin in the affected cells. The organelles of dendrites decreased or disappeared; the neuroglia looked edematous. There were only a few axons which looked edematous in the neuropil. Microinjection of the same volume (1 microliter) of NS into the other side of NTS region in the same rabbit didn't show any sign of damage as those described above. Thus, our preliminary results suggest that tutin might damage the soma and dendrites of some neurons, and therefore, it might be a neuroexcitotoxin.

CD4 expressed on earliest T-lineage precursor cells in the adult murine thymus

A continuous but low input of stem cells or 'prothymocytes' is necessary to maintain T-cell development in the adult thymus, but the colonizing cell has not been characterized. Precursors of T cells have been found in the minor CD4-8- population of thymocytes, but even the earliest cells of this population already have partially rearranged T-cell antigen receptor (TCR) genes. We now demonstrate that the thymus contains a minute population of lymphoid cells similar in some but not all respects to bone marrow-derived haemopoietic stem cells. This population has TCR genes in a germline state. It gives a slow but extensive reconstitution of both alpha beta and gamma delta lineages on transfer into an irradiated thymus, with kinetics indicating that it includes the earliest intrathymic precursor cells so far isolated. Surprisingly, these cells express low surface levels of the mature T-cell marker CD4.

Cyclic nucleotide phosphodiesterase of Dictyostelium discoideum and its glycoprotein inhibitor: structure and expression of their genes

The genes coding for the cyclic nucleotide phosphodiesterase (PD) and the PD inhibitory glycoprotein (PDI) have been cloned and characterized. The PDI gene was isolated as a 1.6 kb genomic fragment, which included the coding sequence containing two small introns and 510 nucleotides of non-translated 5' sequence. From the deduced amino acid sequence we predict a protein with a molecular weight (MW) of 26,000 that, in agreement with previous data, contains 15% cysteine residues. Genomic Southern blot analysis indicates that only one gene encodes the inhibitor. Northern blot analysis shows a single transcript of 0.95 kb. The PDI gene is expressed early in development with little transcript remaining following aggregation. The appearance of PDI mRNA is prevented by the presence of cAMP, but when cAMP is removed the transcript appears within 30 minutes. When cAMP is applied to cells expressing PDI the transcript disappears with a half-life of less than 30 minutes. The PD gene of D. discoideum is transcribed into three mRNAs: a 1.9 kb mRNA specific for growth, a 2.4 kb mRNA specific for aggregation, and a 2.2 kb mRNA specific for late development. The 2.2 kb mRNA is also specific for prestalk cells, and is induced by differentiation-inducing factor. All three mRNAs contain the same coding sequence, and differ only in their 5' non-coding sequences. Each mRNA is transcribed from a different promoter, and by using the chloramphenicol acyltransferase gene as a reporter, we have shown that each promoter displays the same regulation as its cognate mRNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Gated cardiac blood pool studies in atrial fibrillation: role of cycle length windowing

Cycle length windowing is gaining increasing acceptance in gated blood pool imaging of patients with atrial fibrillation (AF). The goals of this study were: to assess differences of ejection fraction (EF) in AF with and without windowing and to determine how EF varied with cycle length in patients with AF. Twenty patients with AF were prospectively studied by gated blood pool imaging, with simultaneous collection in each patient of 5-7 studies with cycle length windows spanning the cycle length histogram. Each window accepted beats of only a narrow range of cycle lengths. EF was determined for each of the narrow cycle length windows as well as for the entire gated blood pool study without cycle length windowing. For every patient an average of the windowed EFs was compared with the non-windowed EF. EF values were similar (mean windowed: 46.6; non-windowed: 45.5; P = 0.16), and there was a good correlation between the two techniques (r = 0.97). The data were then examined for a relationship of EF with cycle length. The difference from average windowed EF (delta EF) was calculated for each window and plotted vs. the cycle length of the center of each window. No predictable linear or nonlinear relationship of delta EF with window position was observed. Lack of predictable variation of EF with cycle length is likely due to lack of a predictable amount of ventricular filling for a given cycle length, as the amount of diastolic filling in AF depends on the random cycle length of the preceding beat.(ABSTRACT TRUNCATED AT 250 WORDS)

2,3,7,8-Tetrachlorodibenzo-p-dioxin induces cytochrome P450IA1 enzyme activity by activating transcription of the corresponding gene

We have reviewed the transcriptional regulation of the CYP1A1 gene, which encodes the cytochrome P450IA1 enzyme. TCDD induces CYP1A1 transcription via a receptor- and enhancer-dependent mechanism that involves multiple protein-DNA interactions. The system provides an example of enzyme regulation at the level of gene transcription.

[Visual pigment genes for color vision defects]

Applying recombinant DNA techniques, the structures of red pigment gene (RPG) and green pigment gene (GPG) were analyzed for 43 patients with protan or deutan (including 3 females), 4 normal relatives and 3 carriers out of 3 families, as well as 11 normal controls. Abnormality of RPG was detected in all 19 protan and that of GPG was found in 14 out of 24 deutan. In about 80% (32/40) of protan and deutan the changing of exon 5 for RPG or GPG was discovered. In protan the normal RPG was replaced by a 5' red -3' green hybrid gene. Some of the deutan had no GPG, some had 5' green -3' red hybrid gene with or without GPG. Furthermore, the exon 5 of RPG and GPG was amplified by polymerase chain reaction (PCR) and further analyzed by Rsa I digestion. The results for PCR are identical to that of Southern blot hybridization.