Human alveolar macrophages: a lesion in arachidonic acid metabolism in cigarette smokers

Human pulmonary macrophages (PAM) recovered from young cigarette smokers and from age- and sex-matched subjects who had never smoked were used to investigate arachidonic acid metabolism. The uptake of radiolabeled arachidonic acid by PAM obtained from smokers and nonsmokers was not significantly different. The phagocytic indexes of the smoker and nonsmoker macrophages were 17.4 X 3.9% and 18.5 +/- 5.0%, respectively. Both smoker and nonsmoker macrophages produced prostaglandin E2 (PGE2), thromboxane B2 (TXB2) and prostaglandin F2 alpha (PGF2 alpha). A significant decrease in PGE2 and TXB2 synthesis but not in PGF2 alpha synthesis by the smoker PAM compared PAM compared with the nonsmoker PAM was observed using 2 different assays to measure prostaglandin production. Nonsmoker macrophages produced 644 +/- 128,239 +/- 53, and 29 +/- 12 ng/1.5 X 10(6) cells of PGE2, TXB2, and PGF2 alpha, respectively, whereas smoker macrophages synthesized 168 +/- 20, 41 +/- 3, and 17 +/- 1 ng/1.5 X 10(6) cells, as measured by radioimmunoassay. Similar differences were observed using isotopic assays. A cigarette-smoke-induced lesion in phospholipid hydrolysis or the mechanism regulating phospholipid hydrolysis seem most consistent with these findings.

Selective and potent beta 2-adrenoceptor agents within the tetrahydroisoquinoline class: effect of methyl substitution at the benzylic carbon of the 1-(3,4,5-trimethoxybenzyl) group of trimetoquinol

A systematic series of methyl (2 and 3) and dimethyl (4) analogues of trimetoquinol (1) were synthesized and evaluated for their beta 1 (atria) and beta 2 (trachea) and adrenoceptor activities. Structural assignments for the erythro (2) and the threo (3) diastereoisomers of 1-(3,4,5-trimethoxy-alpha-methylbenzyl)-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline were based on NMR spectra of the 6,7-dibenzyl precursors 15 and 16, respectively, and on the synthetic derivatives of cis- and trans-13-methyl-2,3-bis(benzyloxy)-9,10,11-trimethoxytetrahydroprotoberberine (18 and 17). The rank order of beta 2-agonist activity for these compounds was 3 greater than 1 greater than 2 greater than 4. The rank order of activity as beta 1 agonists on the guinea pig atria is 1 greater than 3 greater than 2, and 4 was inactive. The methylated analogues show selectivity for beta 2 receptors in our preliminary pharmacological studies. The threo isomer 3 is the most potent and selective beta 2 stimulant reported to date in the tetrahydroisoquinoline class.

Pneumonia in goats caused by Mycoplasma mycoides subspecies mycoides

Mycoplasma mycoides subspecies mycoides (large-colony type) was isolated from the lungs of a goat with pneumonia. Clinical signs included inappetence, weakness, listlessness, coughing, dyspnea, pyrexia, slight nasal discharge, and lameness. Tylosin (4 mg/kg of body weight) was administered each day for 4 days, resulting in slow recovery. Three weeks later, the clinical signs recurred and the kid was anemic. It was given a single blood transfusion and tylosin was administered daily. The kid's health status was steadily declined and it died after 6 days' treatment. At necropsy, the lungs were edematous and congested. Histopathologic findings were those of septicemia and pneumonia.

Double choledochus with ectopic drainage into the stomach-a rare congenital anomaly of the biliary ductal system

A patient with an accessory bile duct originating from the left common hepatic duct and emptying into the stomach along the lesser curvature presented with periodic symptomatic bile gastritis. Reimplantation of the accessory duct into the duodenum relieved his symptoms.

Fatal Yersinia pseudotuberculosis infection in captive bushbabies

Fatal Yersinia pseudotuberculosis infection was diagnosed in 3 bushbabies (Galago crassicaudatus) in a large prosimian colony. The clinical signs were diarrhea, dyspnea, hyperthermia, dehydration, and lethargy. Histologically, the disease was characterized by lesions of ulcerative enterocolitis, necrotizing hepatitis, splenitis, lymphadenitis, and nonsuppurative pneumonitis.

Anti-T antibody in malignant melanoma patients. Influence of response and survival following chemotherapy--changes in serum levels following C parvum, BCG immunization

The level of anti-T antibodies directed towards the precursor T antigen of the MN blood group system was measured in the sera of 55 patients with disseminated melanoma, before and during chemoimmunotherapy. The anti-T titer was subnormal in patients before therapy; patients who responded to therapy had significantly higher titers than did nonresponders in sera taken before therapy, at regression/progression of disease, and during the last pulse of treatment. Higher pretreatment titers were associated with a significntly longer survival time. A single infusion of Corynebacterium parvum was given to 14 other melanoma patients and significant elevation of preimmunization titers was observed on days 14, 21, and 28 after infusion; Bacillus Calmette-Guerin, vaccination of 9 patients did not significantly alter the anti-T titer. The expression of the normally cryptic T antigen on melanoma cells would absorb naturally circulating anti-T antibodies. Less dense expression of T antigen on melanoma cells that were responsive to therapy, i.e., less "malignant," would explain the better prognosis for patients with higher titers. The increase in anti-T antibodies following administration of C parvum but not of BCG is of possible clinical relevance when C parvum is used as an immunotherapeutic agent.

Neutral protease activation of peritoneal macrophage prostaglandin synthesis

We observed that the treatment of murine macrophages with proteolytic enzymes can activate the synthesis and release of arachidonic acid (ARA) metabolites. Murine peritoneal macrophage monolayers prelabeled with [14C]ARA were incubated with neutral proteases. Specific bacterial and mammalian proteases from various sources provoke the synthesis and release of prostaglandin E2 (PGE2) and other radiolabeled metabolites. However, cells treated with the neutral proteases thrombin and trypsin did not release significant amounts of PGE2. Neutral protease treatment did not decrease cell viability (> 90%) and boiled protease preparations did not activate prostaglandin synthesis. Protease-activated PGE2 synthesis was inhibited by a variety of protease inhibitors and synthetic substrates for neutral proteases. An inflammatory agent that induces macrophage neutral protease activity, 12-O-tetradecanoylphorbol 13-acetate (TPA) stimulated synthesis and release of PGE2 in a dose- and time-dependent manner. TPA-activated PGE2 synthesis was also blocked by a variety of protease inhibitors. These results suggest that neutral proteases have the capacity to activate ARA metabolism and imply that neutral proteases found in inflammatory reactions may infuence prostaglandin production.

HBV markers in Chinese in Hong Kong

A study was carried out on 779 hospital patients in the Orthopaedic and Paediatric Unit of Queen Mary Hospital, Hong Kong. Patients who had no clinical evidence of liver disease, previous history of transfusion with blood or blood products and no major surgery in the past were entered into the study. Markers of previous exposure to Hepatitis B virus (HBV) were HBsAg, anti-HBc and anti-HBs (radioimmunoassay) were done. The results showed that (a) Chinese living in Hong Kong are exposed to HBV infection throughout life (b) horizontal transmission is the dominant mode of transmission and (c) cpronic HBsAg carriers probably do not carry HBV for life but may clear HBs antigenaemia with age.

Five-frame, x-ray camera for charged particle, inertial confinement fusion studies

A prototype framing x-ray camera has been developed for photographic studies of inertial confinement fusion (ICF) targets irradiated by charged particle beams. Electron images from five, independently gated, microchannel plates are transported out of the radiation field by means of a toroidal magnetic field and are permanently recorded on film. The calculated, effective exposure time is <or=5 ns (FWHM), and the resolution at the object is presently limited by the x-ray pinhole optics to approximately 0.5 mm. Time-resolved photographic studies have been made of luminous targets irradiated by pulsed electron and ion beams. The camera has also been adapted for single frame, x-radiographic studies of nonluminous imploding targets.

Isolation from murine myeloma and leukemia cells of a selective inhibitor of DNA polymerases

An inhibitor of two ribopolymer-transcribing DNA polymerases can be isolated from MOPC-21 myeloma tumors, from the sera of mice bearing these tumors, or from MCDV-12 ascitic leukemia. The peritoneal fluid of mice bearing the latter neoplasm is also a source of the inhibitor. The inhibitor is a small DNA molecule which displays inhibitory activity in both double- and single-stranded form.

Small tritium filling and monitoring apparatus for particle beam inertial confinement fusion targets

A small gas filling apparatus has been developed to fill a particle beam ICF target with D-T gas mixture seconds before the target is irradiated. Included in the filling apparatus is a novel miniature pressure monitor which determines quantitatively the fill pressure by counting the rate of Beta particles emitted by the decaying tritium atoms.

Percutaneous transluminal angioplasty with the Grüntzig balloon catheter. A review of 70 cases

Percutaneous transluminal angioplasty has been used to treat lesions of the iliac, superficial femoral, and renal arterial systems in 70 patients. Overall initial success was achieved in 27/30 lesions, with 4/5 lesions documented to be patent for longer than two years. Although long-term follow-up is at present limited, the reduced cost and morbidity of this procedure are distinct advantages in appropriately selected patients. The close involvement of the vascular surgeon and a "team" approach are necessary. These preliminary results are part of a long-term study to evaluate the efficacy of transluminal angioplasty as well as to define factors that may be of predictive value in patient selection.

Percutaneous transhepatic portal venography in the diagnosis and management of gastroesophageal varices

Percutaneous transhepatic portal venography is a relatively safe method of obtaining both physiologic and morphologic information in patients with portal hypertension. Precise "road mapping" is performed, as well as measurement of free portal pressure. Additionally, transcatheter obliteration of gastroesophageal varices may produce effective cessation of hemorrhage in patients bleeding from this site, as was done on an emergency basis after failure of intra-arterial vasopressin infusion.

Spontaneous cholangiocarcinoma in a ring-tailed lemur (Lemur catta)

A cholangiocarcinoma in the liver with metastasis to the regional lymph nodes was found in a male ring-tailed lemur (Lemur catta). The liver was partially replaced by a gray-white, coarsely lobulated mass. Microscopically, the tumor consisted of well circumscribed lobules of anaplastic, low cuboidal cells occasionally arranged in duct-like structures. The tumor did not involve the gallbladder.

Advances in the management of bile duct obstruction: percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography

Jaundice can be diagnosed anatomically and frequently histopathologically without laparotomy by radiologic and endoscopic techniques, combined with biopsy or cytology. Benign and malignant causes of bile duct obstruction can be managed by endoscopic and radiologic methods with reduced morbidity and mortality, displacing abdominal operation for many entities. Even unresectable or inoperable lesions can be effectively palliated by these new techniques.

Percutaneous transluminal angioplasty for treatment of renovascular hypertension

Four patients with typical renovascular hypertension due to atherosclerotic stenosis (3 patients) and near occlusion (one patient) were treated with percutaneous transluminal angioplasty (PTA). Two patients had malignant hypertension by clinical standards. All had significant reduction in blood pressure following angioplasty, resulting in either a normotensive state, or management with significantly less antihypertensive medication. Patency and normal renin levels were achieved within two months in 2 patients. Clinical follow-up documented continued reduction in blood pressure. Advantages of the procedure include local anesthesia, relatively little discomfort, repeatability, and the fact that surgery is not precluded if angioplasty is unsuccessful.

Percutaneous transluminal angioplasty with the Grüntzig balloon catheter

The results of an ongoing five-year study of percutaneous transluminal angioplasty for the treatment of peripheral vascular disease are presented. A balloon catheter was used for iliac and superficial femoral and popliteal artery dilatation. Forty out of 43 procedures performed were considered to have initial success, with iliac angioplasty showing a greater success rate (96%) than superficial femoral angioplasty (90%). Complications requiring surgical intervention occurred in only 3 patients. Advantages of this technique include local anesthesia, early ambulation, reduced hospital stay, and reproducibility.

Percutaneous transluminal angioplasty (PTA) with the Grüntzig balloon catheter: technical problems encountered in the first forty patients

Forty patients have undergone percutaneous transluminal angioplasty (PTA) of the iliac or femoral-popliteal system with the Grüntzig balloon catheter. Technical problems ahve included experience with difficult antegrade puncture, production of intimal flaps, and loss of collateral vessels, as well as the need to develop an approach for recanalization of obstructions and for use of the balloon. Since problems in these areas may jeopardize the success of the procedure, they have been elucidated with some discussion of prevention. Preliminary results on the success of the procedure are included.

Transcatheter gelfoam embolization of posttraumatic bleeding pseudoaneurysms

Diagnostic angiography combined with transcatheter therapeutic embolization is a simple and effective means of treating complex clinical situations associated with posttraumatic hemorrhage. Bleeding pseudoaneurysms, even when large, can be readily managed by this combined modality with resultant decrease in morbidity and hospital stay. Five patients with posttraumatic pseudoaneurysms are presented. All five were treated by transcatheter therapeutic embolization with Gelfoam. Of these five cases, three involved extremities, one involved the retroperitoneal space, and the last was of renal origin. Two of the five cases still required surgical intervention after initial successful therapeutic embolization, one for recurrent bleeding from collaterals and the other for evacuation of a massive pseudoaneurysm which was causing distraction of fracture fragments. The early use of angiography in suspected cases of posttraumatic hemorrhage, together with careful evaluation of potential collateral supply, is stressed. The use of transcatheter therapeutic embolization in the extremities as presented here is yet another example of the ever-broadening applicability of this technique.

Transcatheter arterial embolization of a traumatic lumbar artery false aneurysm

The case of a false aneurysm of a lumbar artery secondary to penetrating trauma is presented. Problems of diagnosis are outlined, emphasizing the value of ultrasound, computerized tomography, and angiography. The early use of angiography is strongly advocated in cases of suspected post-traumatic bleeding. The use and value of therapeutic transcatheter embolization is discussed.