Identification and characterization of a nuclear localization sequence-binding protein in yeast

Nuclear proteins contain specific regions that are required for entry into the nucleus. Using ligand blotting, we have shown that a 67-kDa yeast nuclear envelope protein (p67) recognizes synthetic peptides containing the yeast histone H2B or simian virus 40 large tumor antigen nuclear localization sequence. Both free peptide and peptide conjugated to human serum albumin are recognized. The interaction between p67 and the nuclear localization sequences is specific; neither a mutant peptide that is incompetent for nuclear transport in vivo nor HSA can interact with p67 on blots. Moreover, although the wild-type peptide competes for binding to p67, the mutant peptides do not. p67 appears to be located at the nuclear envelope and is not present in other subcellular fractions. The nuclear localization sequence-binding protein is not extracted from the nuclear envelope with nonionic detergents and only partially extracted with high-salt buffer or 8 M urea, suggestive of a tight association with the nuclear envelope. Together our results are consistent with a role for p67 in nuclear transport.

Surgical treatment of salivary gland tumors

Two hundred fifteen patients (74.14%) with benign tumors and 75 patients (25.86%) with malignant tumors of the salivary glands were analyzed. One hundred eighty-five of these patients were followed for 1 to 20 years postoperatively. Of 150 benign tumors, recurrence was noted in 15 cases (9.75%). The 5-year recurrence rate was 7.82%. With the malignant tumors, recurrence was noted in 16 patients (51.6%). The 5-year recurrence rate was 27.75%.

The need for definitive therapy in the management of perforated gastric ulcers. Review of 202 cases

A retrospective study of 202 patients who presented to three Louisiana hospitals with perforated gastric ulcers was performed. Patients were treated surgically, medically, or were not treated. Only those patients with gastric ulcers were included in the study, not those with "channel ulcers" or peptic ulcers. The mortality rate of the 185 patients who were treated with operation was 18%. Of those patients treated nonoperatively, the mortality was 95% (one survivor). There was a definite difference in mortality among those patients treated with definitive operative procedures (11.3%) versus those patients treated with nondefinitive surgery (22.9%). This difference was consistent even in the presence of purulent exudate in the abdominal cavity and among those patients presenting in shock. The mortality among those patients who presented with a initial blood pressure of 90 mmHg or less were defined as being in shock, and the mortality in this subgroup was 52.8%. The mortality among those patients who had purulent fluid within the abdominal cavity was about the same, regardless of type of surgical procedure. The patients who underwent nondefinitive procedures required subsequent operative treatment in 25.7% of cases. Also noted was the lack of correlation between symptoms of ulcer disease and perforation. Those patients treated with definitive surgery (57%) and those treated with nondefinitive surgery (41%) reported no symptoms consistent with ulcer disease before operation.

Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women

STUDY OBJECTIVE

To assess the effect of weight-bearing exercise training and subsequent detraining on lumbar bone mineral content in postmenopausal women.

DESIGN

Non-randomized, controlled, short-term (9 months) trial and long-term (22 months) exercise training and detraining (13 months).

SETTING

Section of applied physiology at a university school of medicine.

PATIENTS

Thirty-five healthy, sedentary postmenopausal women, 55 to 70 years old. All women completed the study. There was 90% compliance with exercise training.

INTERVENTIONS

All women were given calcium, 1500 mg daily. The exercise group did weight-bearing exercise (walking, jogging, stair climbing) at 70% to 90% of maximal oxygen uptake capacity for 50 to 60 min, 3 times weekly.

MEASUREMENTS AND MAIN RESULTS

Bone mineral content increased 5.2% (95% confidence interval [CI], 2.0% to 8.4%; P = 0.0037) above baseline after short-term training whereas there was no change (-1.4%) in the control group. After 22 months of exercise, bone mineral content was 6.1% (95% CI, 3.9% to 8.3% above baseline; P = 0.0001) in the long-term training group. After 13 months of decreased activity, bone mass was 1.1% above baseline in the detraining group.

CONCLUSIONS

Weight-bearing exercise led to significant increases above baseline in bone mineral content which were maintained with continued training in older, postmenopausal women. With reduced weight-bearing exercise, bone mass reverted to baseline levels. Further studies are needed to determine the threshold exercise prescription that will produce significant increases in bone mass.

Cecal diverticulitis: changing trends in management

Diagnosis of cecal diverticulitis remains a dilemma. Preoperatively it can mimic appendicitis, and intraoperatively the surgeon is confronted with an inflammatory mass that may masquerade as a neoplasm. We reviewed 18 cases of pathologically documented cecal diverticulitis and one case of solitary diverticulitis of the ascending colon. Ileocolonic resection was done in 16 patients, and three patients had local resection. Patients having local resection had greater morbidity and a significantly longer hospital stay. There were no deaths. We have found ileocolonic resection to be safe and effective, and we recommend it as the procedure of choice for cecal diverticulitis.

The effect of preoperative total parenteral nutrition on surgery outcomes

The effect of preoperative total parenteral nutrition (TPN) on morbidity and mortality was studied in medical records of discharged surgical patients. Patients were classified into two groups on the basis of their ability to meet established criteria for malnutrition and the use of preoperative or postoperative TPN. The control group consisted of 44 patients who received TPN only after surgery or for less than 5 days preoperatively. The experimental group consisted of 26 patients who received treatment for at least 5 days before surgery and/or after surgery. Nutrition parameters measured included serum albumin, total lymphocyte count, hemoglobin, weight, and percent weight loss. Major septic complications (MSC) considered were intra-abdominal sepsis, wound dehiscence, septicemia, and pneumonia. Other complications included respiratory failure, congestive heart failure, fistulas, urinary tract infection, shock, and death. The experimental group showed improvements after surgery in the nutritional parameters listed and had a lower incidence of morbidity and mortality. Deficits in serum albumin, total lymphocyte count, and weight losses greater than or equal to 10% have been significantly (p less than .01) linked to the incidence of MSC. MSC also has been more frequently noted among patients who did not have TPN prior to surgery and who died following surgery. Therefore, preoperative TPN does appear to make a difference in the outcome of surgery.

Surgical treatment of pleomorphic adenoma of the parotid gland: report of 110 cases

One hundred benign and ten malignant pleomorphic adenomas of the parotid gland were analyzed. Follow up ranged from two to 20 years. Of 54 cases of benign pleomorphic adenoma of the parotid gland, recurrence was noted in five cases (9.2%). The five-year recurrence rate was 17.2%. Of the six malignant pleomorphic adenoma, recurrence within the first ten years took place in four patients (66.6%).

Ileosigmoid knot

A 30-year-old black man had emergency surgery for an acute abdominal condition. Intraoperative diagnosis of an ileosigmoid knot was made and gangrenous bowel was resected, with ilioileostomy, reanastomosis, end colostomy, and Hartmann pouch.

Possible role of tensile stress in the etiology of cervical erosive lesions of teeth

A tensile stress hypothesis for the etiology of idiopathic cervical erosions of human teeth is presented. It is proposed that when occlusion is not ideal, lateral forces cause the teeth to bend. The tensile stresses created during bending disrupt the chemical bonds of the crystalline structures of enamel and dentin. Small molecules may enter between the crystals and prevent the reestablishment of the chemical bonds. As a result, the disrupted tooth structure is more susceptible to loss through dissolution and abrasion and results in the development of the typically wedge-shaped lesions. Patients with lesions typical of hundreds examined by the authors were presented to illustrate the concept. The possible consequences of the proposed hypothesis were discussed. The hypothetical conclusions made in this article will be tested by experimentation.

Surgical judgment in the management of abdominal stab wounds. Utilizing clinical criteria from a 10-year experience

A 10-year retrospective study of patients with stab wounds to the abdomen managed under a protocol of selective management has been performed. Patients were assessed on the basis of clinical presentation and physical examination, with minimal diagnostic studies. Peritoneal lavage was not utilized in the evaluation of the patients. Two hundred and nineteen such patients were identified. One hundred and eleven of these patients were treated nonoperatively. Ninety patients were treated by immediate laparotomy. Eighteen patients, initially observed, underwent delayed laparotomy. One patient, not explored despite clear-cut indications for laparotomy, died of sepsis, emphasizing the need for strict adherence to the stated protocol. The negative or unnecessary laparotomy rate was 7.8%. The false-negative examination rate was 5.5%. Overall mortality rate was 2.3%. The accuracy of careful clinical evaluation and observation is comparable to, or better than, any other method currently available to identify intra-abdominal injuries in patients with abdominal stab wounds. The study suggests that selective management of stab wounds of the abdomen may be safely practiced in a smaller community hospital.

Hepatitis B antigen in infants born to mothers with chronic hepatitis B antigenemia in Taiwan

Hepatitis B antigen (HB Ag) was detected by complement fixation (CF) in serum samples of 7.5% of 1,106 pregnant Chinese women tested in Taipei, Taiwan. HG Ag persisted in all but one of 42 women followed for 1 to 18 months (average, nine months) after delivery, and 27 of the 43 infants (63%) born to those women became antigen-positive. Persistance of the antigen was more common than transient or intermittent antigenemia. Twelve had antigenemia when first tested, while 15 later developed antigenemia, usually during the first six months of life. Only one infant developed antibody to HG Ag (anti-HB Ag), and this occurred after transient antigenemia. The HB Ag was found in two of 32 (6%) fathers, and in 18 of 27 (67%) older siblings. The antigen was more common among siblings of antigen-positive than among those of antigen-negative infants. These findings demonstrate that in Taiwan, infants born to mothers who are asymptomatic carriers of HB Ag commonly become infected by heaptitis B (HB) virus. Exposure of infants near the time of birth may be important maintaining the high, chronic HB Ag carrier rate in Taiwan.

Particle deposition in systems of repeatedly bifurcating tubes

Deposition of half-micron particles from steady inspiratory flows was measured in the daughter branches of the second bifurcations in a symmetric airway model consisting of two successive generations of bifurcation. Two different configurations were studied: (1) both bifurcations in the same plane and (2) the second bifurcation normal to the plane of the first. The results indicate that the deposition in the daughter branches in configuration (2) is relatively uniform, while that in configuration (1) has a distinct second deposition hot spot, in addition to the one at the carinal ridge. The deposition velocities in the branch which has secondary flows in the opposite sense to those in its parent branch are about 50% lower than those in other types of branches. The deposition patterns are consistent with the observed flow profiles in these tubes.

Vertical transmission of hepatitis B antigen in Taiwan

To determine the frequency of vertical transmission of hepatitis B antigen (HB5 Ag) from asymptomatic carrier mothers in Taiwan to their offspring, HB5 Ag was sought by radioimmunoassay and complement fixation. Of 158 babies born to carrier mothers, antigenemia developed in 63; 51 of these antigenemic babies had become antigen positive within the six months of life. Three inter-related factors were found to increase the risk that antigenemia would develop in the infant: a high maternal complement-fixation titer for HB5 Ag: presence of HB5 Ag in the baby's umbilical-cord blood: and antigenemia in siblings. In contrast to previous studies, these findings indicate that vertical transmission from carrier mothers frequently occurs, at least in Taiwan, and may partially explain Taiwan's high prevalence of HB5 Ag.