Umbilical blood flow velocity waveforms in different maternal positions and with epidural analgesia

Umbilical blood flow velocity waves were measured in the fetuses of healthy parturients in early active labor to assess the influence of different maternal positions (N = 16) and of epidural analgesia (N = 16). The ratio of systolic peak to diastolic trough (S/D) of the umbilical blood flow velocity wave is reflective of vascular resistance distal to the point of measurement on the fetal side of the placenta. Umbilical blood flow velocity wave S/D ratios were significantly higher in the supine than in either lateral position indicating that umbilical artery vascular resistance is increased when the mother lies supine. After epidural blockade, the S/D ratios were unchanged in three and lowered to varying degrees in 13 parturients indicating that this method of pain relief beneficially affects umbilical artery vascular resistance.

Electrocardiograph voltage in fit young men

Several criteria exist for the diagnosis for left ventricular hypertrophy as shown by high voltage on the electrocardiograph. This study of 200 healthy young recruits to the Royal Artillery with normal blood pressure and normal left ventricular wall thickness as measured by echocardiography [corrected] shows that no matter which criteria are used the false positive rate is approximately 25%. High voltage is a normal phenomenon in young men and its use as a predictor of left ventricular hypertrophy is likely to be misleading in this age group.

The natural history of asthma in childhood

The incidence and prognosis of childhood asthma and wheezing illness (AW) was studied using data obtained at ages 7, 11, and 16 from a national cohort of 8806 children born in 1958. By the age of 16, 24.7% were reported to have experienced at least one episode of AW. In 18.3% AW had started before the age of 8, but only 4.2% continued to have symptoms in later childhood. A further 3.6% began to have AW between the ages of 8 and 11, and 2.8% began between the ages of 12 and 16. Of those with AW at age 7, 28.3% had symptoms at 11 and 16.5% at 16; these proportions were about doubled if AW at 7 had been severe. The associations between natural history and a large number of perinatal, social, environmental, and medical factors were examined. Those which predicted the onset of AW after the age of 7 were: male sex of child; mother aged 15-19 at child's birth; history of pneumonia, whooping cough, throat or ear infections or tonsillectomy; eczema, allergic rhinitis; and periodic vomiting or abdominal pain.

Effects of 6-hydroxydopamine-induced lesions of the paraventricular nucleus, and of prazosin, on the corticosterone response to restraint in rats

In rats, with bilateral lesions of the paraventricular nuclei induced by 6-hydroxydopamine, restraint stress failed to elevate levels of corticosterone in plasma, although the resting levels in lesioned animals were similar to those of control rats. Prazosin inhibited the plasma-corticosterone response to restraint in intact rats, at doses which did not by themselves influence resting hormone levels. These results suggest a positive role for noradrenaline, acting through alpha-adrenoceptors, on the stress-induced output of corticotrophin.

2-Amino-7-phosphonoheptanoic acid (2-APH) infusion into entopeduncular nucleus protects against limbic seizures in rats

Motor limbic seizures occur following a systemic injection of pilocarpine (380 mg/kg) in rats. Focal injection of the selective N-methyl-D-aspartate receptor antagonist, (+/-)-2-amino-7-phosphonoheptanoic acid (2-APH, 5-20 pmol), bilaterally into the entopeduncular nucleus (EP) prior to pilocarine blocks these seizures. Muscimol (50 pmol), a potent gamma-aminobutyric acid receptor agonist, injected bilaterally into EP produces a similar protection against pilocarpine-induced seizures. Thus by blocking excitatory neurotransmission or facilitating inhibition within the EP, the severity of limbic seizures can be reduced.

The cholesterol storage disorder of the mutant BALB/c mouse. A primary genetic lesion closely linked to defective esterification of exogenously derived cholesterol and its relationship to human type C Niemann-Pick disease

An inborn murine cholesterol storage disorder exists which is characterized by a lesion in intracellular cholesterol esterification not accounted for by any discernible abnormality in acyl-CoA: cholesterol acyltransferase (Pentchev, P.G., Boothe, A.D., Kruth, H.S., Weintroub, H., Stivers, J., and Brady, R.O. (1984) J. Biol. Chem. 259, 5784-5791). Current studies have shown that the level of esterification of nonlipoprotein-derived [3H]cholesterol in cultured fibroblasts from heterozygous mutant mice was intermediary between the level found in normal fibroblasts and the deficient level found in fibroblasts from homozygous mutant mice. Homozygous-affected fibroblasts took up and converted [3H]desmosterol to [3H]cholesterol at a normal rate indicating that the murine mutation does not compromise the transport of exogenous sterol to microsomes. In contrast to the defect in esterification of exogenously derived cholesterol, synthesis of cholesteryl ester from [3H]mevalonic acid and [3H]squalene was normal in affected fibroblasts as was the stimulation of cholesteryl ester synthesis from endogenous cholesterol induced by 25-hydroxycholesterol. In surveying a number of mutant cell lines from human metabolic disorders with phenotypic manifestations similar in part to the mutant cholesterol storage mouse, Niemann-Pick C fibroblasts displayed a similar defect in esterification of exogenously derived cholesterol.

Specific detection of noradrenaline in the rat brain by using antibodies

Noradrenaline (NA) was conjugated to different protein carriers with glutaraldehyde. During the catecholamine conjugate synthesis, precautions were taken in order to preserve the structure of NA. Anti-NA antibodies were raised in rabbits and tested using a modified enzyme-linked immunosorbent assay and immunocytochemistry. The most immunoreactive antigen was found to be the reduced NA conjugate. The octopamine conjugate was recognized by the NA antiserum 16 X less than the reduced NA conjugate. The other conjugates, dopamine, L-dihydroxyphenylalanine and adrenaline were poorly recognized by the anti-NA antibodies. A good correlation was found between results obtained using the in vitro enzyme-linked immunosorbent assay and immunocytochemistry.

GABA neurones in retinas of different species and their postnatal development in situ and in culture in the rabbit retina

The localisation of GABA immunoreactive neurones in retinas of a variety of animals was examined. Immunoreactivity was associated with specific populations of amacrine neurones in all species examined, viz. rat, rabbit, goldfish, frog, pigeon and guinea-pig. All species, with the exception of the frog, possessed immunoreactive perikarya in their retinal ganglion cell layers. These perikarya are probably displaced amacrine cells because GABA immunoreactivity was absent from the optic nerves and destruction of the rat optic nerve did not result in degeneration of these cells. GABA immunoreactivity was also associated with the outer plexiform layers of all the retinas studied; these processes are derived from GABA-positive horizontal cells in rat, rabbit, frog, pigeon and goldfish retinas, from bipolar-like cells in the frog, and probably from interplexiform cells in the guinea-pig retina. The development of GABA-positive neurones in the rabbit retina was also analysed. Immunoreactivity was clearly associated with subpopulations of amacrine and horizontal cells on the second postnatal day. The immunoreactivity at this stage is strong, and fairly well developed processes are apparent. The intensity of the immunoreactivity increases with development in the case of the amacrine cells. The immunoreactive neurones appear fully developed at about the 8th postnatal day, although the immunoreactivity in the inner plexiform layer becomes more dispersed as development proceeds. The immunoreactive horizontal cells become less apparent as development proceeds, but they can still be seen in the adult retina. The GABA immunoreactive cells in rabbit retinas can be maintained in culture.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of serotonin and 5-methoxytryptamine immunoreactivity in rat raphe nuclei

We studied the immunoreactivity of 5-methoxytryptamine (MT) and 5-hydroxytryptamine (HT) in the raphe region of rats using specific polyclonal antibodies and the peroxidase/anti-peroxidase (PAP) technique. Overall, the patterns of the specific staining for these two antibodies were found to be the same in this region of the rat brain. The staining reaction was considerably less intense for MT than for HT. Specificity tests were performed using HT, MT and tryptamine (T) conjugates at concentrations of 5 X 10(-8) M for antibodies to HT and 2.5 X 10(-9) M for antibodies to MT. Although the distribution of HT-like and MT-like immunoreactivity broadly overlapped, the results obtained from adsorption-specificity tests confirmed the presence of specific MT staining in the rat raphe.

The biochemical and immunocytochemical characterisation of an antigen on the membrane of basal cells of the epidermis

A murine monoclonal antibody, LICR-LON-23.10, which had been raised against a well-differentiated squamous cell carcinoma cell line (LICR-LON-HN5), recognises an antigen which is present on the membrane of basal cells of the epidermis. The tissue distribution of the antigen, as defined using immunohistochemical techniques, suggests that it is expressed preferentially on cells which are adjacent to a basement membrane. In squamous cell carcinomas, the antigen is expressed uniformly on undifferentiated cells, but in areas of keratinisation, the antigen is absent. The antigen recognised by the antibody was characterised as being a pair of glycoproteins with molecular masses of 120 and 135 daltons. The antibody was used for flow-cytometric analyses of epidermal keratinocyte preparations. Together with other basal cell markers, this antibody may be useful in the characterisation of the epidermal basal cell population as well as in broadening our understanding of the interaction between epithelial cell populations and their relationship with basement-membrane components.

Reading attainment and physical development after whooping cough

Anthropometric measurements were made on 360 primary school children with a history of whooping cough and on 711 controls. Altogether 245 (68%) cases and 469 (66%) controls had taken tests of reading attainment and a smaller number had taken tests of intelligence. No significant differences were found between cases and controls in any of the anthropometric measurements nor in reading age or intelligence quotient after controlling for social class and parental smoking. Whooping cough is, in general, unlikely to cause subsequent deficiency in physical or mental development.

A lesioning and 2-deoxyglucose study of the hyperactivity produced by an intra-accumbens dopamine agonist

Lesioning and 2-deoxyglucose (2-DG) autoradiographic studies were applied to the hyperactivity induced in rats by intra-accumbens treatment with the dopamine agonist 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydro-naphthalene (ADTN). Lesions made in substantia innominata and rostro-ventral globus pallidus both attenuated the hyperactivity although no consistent changes in 2-DG uptake were recorded in these areas. Compared to normal rats, hyperactive rats showed greatly increased glucose utilization in the subthalamic nucleus and lateral habenula. Lesioning the subthalamic nucleus greatly reduced the hyperactivity, whereas a lateral habenula lesion was ineffective. Hyperactivity was associated with a discrete, bilateral area of increased 2-DG uptake in the reticular formation which corresponded to the description of the deep mesencephalic nucleus (DMN). Lesions made in the DMN greatly attenuated the hyperactivity response. The DMN may be a locomotor region in the rat.

A defect in cholesterol esterification in Niemann-Pick disease (type C) patients

The demonstration of a defect of cholesterol esterification in a mutant strain of BALB/c mice with an attendant reduction of sphingomyelinase activity [Pentchev, P. G., Boothe, A. D., Kruth, H.S., Weintroub, H., Stivers, J. & Brady, R. O. (1984) J. Biol. Chem. 259, 5784-5791] prompted us to examine the capacity of cultured human Niemann-Pick fibroblasts to esterify exogenously derived cholesterol. Cholesterol was supplied to cell cultures in the form of native or chemically modified, positively charged low density lipoprotein or as non-lipoprotein cholesterol. Cholesterol esterification was not impaired in cell cultures derived from patients with type A or B Niemann-Pick disease. However, esterification of exogenously administered cholesterol was deficient in 20 type C Niemann-Pick cell lines that were available for testing. Fluorescence histochemical staining of unesterified cholesterol in type C cells suggested that these cells were able to internalize and lysosomally process lipoprotein cholesterol. Acyl-CoA:cholesterol acyltransferase activity did not appear deficient in type C cell extracts. The error in cholesterol esterification may provide an opportunity for probing the molecular lesion in this disorder and may afford a useful and reliable means for establishing diagnosis.

Pheochromocytoma: operative strategy

We studied 28 patients who had undergone 30 operations for pheochromocytoma since 1964. The tumor types included bilateral, extra-adrenal, malignant, recurrent, and multiple endocrine neoplasia, with 20 tumors confined to the adrenal gland. The preoperative studies used to localize the tumor included ultrasonography, intravenous urography, angiography, and computed tomography. Patients underwent exploratory operations via flank, subcostal, bilateral subcostal, midline, or thoracoabdominal approaches. In one case, that of a recurrence after bilateral adrenalectomy, surgical exploration discovered a tumor that had not been localized during the preoperative workup. Two patients underwent splenectomy because of injury incurred during operative exploration. Our experience suggests that preoperative localization is highly reliable, and therefore the benefits of extensive surgical exploration may be outweighed by its risks. We believe that with the exception of tumors that occur in association with childhood or pregnancy, multiple endocrine neoplastic syndromes, or recurrent disease, a direct approach to the tumor, possibly via the flank, is justified. Our results suggest that exploration of the contralateral adrenal or periaortic area is not so important as to be worth jeopardizing the spleen or other organs by a complex or extensive dissection.

Three synchronous multiorgan primary cancers. All stage I

A patient who has three separate, synchronous, early (stage I) primary cancers of the right lung, right breast, and stomach and whose disease is simultaneously diagnosed and successfully treated sequentially within a single hospital admission is unique. While multiple primary malignant neoplasms are not uncommon, to our knowledge, there has been no report of triple stage I synchronous carcinomas in separate major organ systems. Age, immunodeficiency, somatotype, hereditary tendencies, hormonal and environmental factors, and previous therapy have been incriminated as etiologic factors. Accurate tissue diagnosis and tumor staging are mandatory. In patients with diagnosed cancer, pulmonary lesions should never be presumed metastatic. Individual tumors should be treated independently of other concomitant lesions, and each treatment approach should be curative in nature. Patients with proven multiple malignant neoplasms carry a higher risk of developing other primary neoplasms.

Neuropeptide Y (NPY)-like immunoreactive amacrine cells in retinas of frog and goldfish

The distribution of neuropeptide Y (NPY)-like immunoreactivity in rat, rabbit, chick, frog and goldfish retinas was investigated by immunohistochemistry. Positive results were observed only in the frog and goldfish retinas. NPY immunoreactivity was associated with a small population of amacrine cell bodies in the inner nuclear layer and cell processes in the inner plexiform layer of both retinas. In the frog retina, three distinct layers containing immunoreactivity were observed in the inner plexiform layer. In contrast, the immunoreactivity in the same area of the goldfish retina was more or less separated into two layers. Convincing evidence could not be found for the co-existence of NPY-like material with other putative transmitter-like substances in the two retinas. Radioimmunoassay revealed the presence of small amounts of NPY-like immunoreactivity in the rabbit retina; the goldfish and frog retinas contained significantly more immunoreactive material. High performance liquid chromatography of the immunoreactive material in frog and goldfish retinas showed each retina containing different molecular forms of NPY-like proteins, neither of which resembled porcine NPY or PYY. The endogenous NPY-like material of the frog retina can be released by potassium depolarisation in a calcium-dependent way. In view of all these data an NPY-like protein must now be considered a potential retinal transmitter.

Protein synthesis and secretion by the human endometrium and decidua during early pregnancy

To investigate the role of the endometrium in sustaining early pregnancy, specimens of endometrium from early pregnancy were incubated in vitro with radiolabelled amino acids, and protein synthesis and secretion were studied by subsequent fluorographic analysis of one-and two-dimensional polyacrylamide gels. Seventeen secreted endometrial proteins (EP) were identified. Changes were demonstrated in the rate of synthesis and/or secretion of a number of these proteins during early pregnancy. Two proteins, EP 14 and EP 15, are the principal secretory proteins of pregnancy endometrium. EP 14 (subunit mol. wt 32 000) is associated with decidualized endometrium and its rate of synthesis/secretion increases during early pregnancy. EP 15 (subunit mol. wt 28 000) is also synthesized and secreted by the secretory endometrium during the menstrual cycle, and during early pregnancy, but its secretion declines to undetectable levels by week 15-16. These proteins may provide useful markers of endometrial function and differentiation during the menstrual cycle and pregnancy.

Acute cerebral revascularization

Fifteen patients evaluated for acute cerebral ischemia underwent acute cerebral revascularization between March, 1979, and May, 1983. Clinical presentation included crescendo transient ischemic attacks (TIA's) in eight cases, progressing neurological dysfunction in three cases, and completed nonfluctuating deficits in four cases. Nine patients received intravenous heparin but did not improve neurologically. The patients with crescendo TIA's were operated on within 4 hours of their last event; those with progressing deficits were operated on while the deficit was developing, and those with established deficits were operated on 4, 6, 9, and 12 hours, respectively, after the event began. The clinical picture for 10 patients had resolved within 10 hours after surgery. One patient with crescendo TIA's, two with progressing deficits, and two with established deficits had postoperative residual deficits, of which three were mild and two severe. One patient, who had a saphenous vein graft to the middle cerebral artery, developed an intracerebral hematoma. In this prospective noncontrolled nonrandomized study, acute cerebral revascularization was performed safely, had limited risks, and offered the potential to help some patients. Further controlled randomized studies are indicated.

Inhibition by metoprolol of the antihypertensive effect of aspirin in young rats

A group of 21-day-old, spontaneous hypertensive rats (SHR) received either aspirin (75-100 mg/kg), metoprolol (1.0-1.5 mg/kg) or both in their drinking water for 56 days. Controls received plain water. Groups of normotensive Wistar-Kyoto rats (WKY) received the same drug treatment as did the SHR. Blood pressure, heart rate and body weight were determined weekly, and water consumption was monitored on a daily basis. Renal prostaglandin (PG) activities were determined in a separate group of rats at 7 and at 56 days on each protocol. Blood pressures in the SHRs remained in the range of the WKY during 56 days of treatment with aspirin or metoprolol, but increased to hypertensive levels after exposure to plain water. Blood pressures in the WKY receiving aspirin or metoprolol were also lower than those receiving plain water, but the antihypertensive effect was somewhat slower in onset. The antihypertensive effects of aspirin and of metoprolol were lost in the SHR but not in the WKY when both drugs were given simultaneously in the drinking water. In comparison to rats receiving plain water, renal PG activity (PGF1 alpha and PGF2 alpha) was lower in rats receiving aspirin, metoprolol or both together. The mechanism for the antihypertensive effect of aspirin in the young SHR may be related to a decline in renal PG content, or to the release of other hormones controlling water and electrolyte balance. Reports that the cyclooxygenase inhibitors, such as aspirin, can block the antihypertensive effect of the beta adrenoceptor antagonists is confirmed in chronic studies using the SHR model.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypercalcemia in carcinoma of prostate. Its cure by orchiectomy

A case report of a patient with carcinoma of the prostate and hypercalcemia is presented. We believe this is the first such case documenting ectopic parathormone from this tumor. Resolution of the hypercalcemia followed orchiectomy.

Immunochemical detection and characterization of pregnancy-associated endometrial alpha 1- and alpha 2-globulins secreted by human endometrium and decidua

Antisera raised against the soluble antigens of the endometrium of early pregnancy detected two antigenic proteins of alpha 1 and alpha 2 mobility in extracts of this tissue and were termed antigens A and B. Neither antigen was detected in pregnancy sera or extracts of proliferative endometrium, but antigen B was detected in extracts of secretory endometrium and both were present in amniotic fluid and medium from in-vitro incubations of pregnancy endometrium. Fractionation of radiolabelled medium on ion-exchange chromatography demonstrated that antigens A and B co-eluted with the proteins from which EP14 and EP15 were derived and which were the major secretory polypeptides of pregnancy endometrium in vitro. Further biochemical purification revealed that EP14 (Mr 32 000) was derived from a protein of native molecular weight 36 000 which existed in two forms, whereas EP15 (Mr 28 000) was derived from a dimeric glycoprotein of native molecular weight 56 000. Immunochemical studies demonstrated that antigens A and B are identical to these two secretory proteins and have been termed pregnancy-associated endometrial alpha 1- and alpha 2-globulins (alpha 1- and alpha 2-PEG).

Nutritional assessment in patients with chronic gastrointestinal symptoms: comparison of functional and organic disorders

We assessed the nutritional status of 119 patients with chronic gastrointestinal symptoms due to organic disorders (inflammatory bowel disease, IBD; peptic ulcer, PU; malabsorption syndrome, M; and malignant gastrointestinal tumours, T), by standard anthropometry and marker proteins (albumin; retinol-binding protein, RBP; and thyroxine-binding prealbumin, TBPA). We also studied 31 patients with irritable bowel syndrome (IBS) and 75 age-matched healthy controls (C). Compared with healthy controls, patients with organic bowel disease had significant abnormality of two or more anthropometric measurements (P less than 0.05). Plasma albumin was reduced in patients with IBD, M and T (P less than 0.001), but RBP and TBPA measurements were lower in all patient categories (P less than 0.01) including IBS. Stepwise discriminant analysis of the patient data alone, using three to six parameters, correctly separated 65 per cent PU patients, 66 per cent IBD and M, 72 per cent IBS and 88 per cent patients with T from other disease categories. We conclude that patients with chronic gastrointestinal symptoms often have some nutritional disturbances and that simple anthropometric and protein measurements might help us to distinguish patients with functional bowel disease from those with organic bowel disease.