Derepression of HPRT locus on inactive X chromosome of human lymphoblastoid cell line

Human XX lymphoblastoid cells with a deletion in the HPRT locus on the active X were exposed to HPRT clone pHPT32. HPRT+ isolates GPT3 and GPT5 lacked pHPT32 DNA, suggesting that their HPRT+ phenotype resulted from expression of a cellular gene. GPT3 mutated to thioguanine resistance at least 100 times more frequently than cells in which the expressed HPRT locus was on the active X. Most GPT3-derived HPRT- had lost one entire X chromosome, indicating that the HPRT+ phenotype of GPT3 resulted from derepression of the HPRT locus on its inactive X. Virtually unchanged G6PD and PGK activities and the presence of a late-replicating X in GPT3 suggest that derepression of the inactive X was not general. Eleven of the GPT3-derived mutants had a tiny centric remnant that may result from a frequently operative mechanism of X chromosome loss. The detection of partial or complete loss of an X by direct selection presents unusual opportunities for genotoxicity detection with human cells.

Glandular lesions of the uterine cervix: the present state of our knowledge

The assessment of squamous lesions of the uterine cervix is a major preoccupation of diagnostic histopathologists and this can overshadow the recognition of significant abnormalities affecting the adjacent endocervical glands. This review gives an account of recent advances in our knowledge of the histology and histochemistry of endocervical glands. The review of benign lesions concentrates on those that continue to cause diagnostic difficulty. Adenocarcinoma in situ, lesser degrees of possibly pre-malignant cervical glandular atypia and histological subtypes of adenocarcinoma are outlined. The increasing awareness that glandular and squamous lesions often co-exist is emphasized. Finally, adenocarcinoma metastatic to the cervix is discussed.

Cervical glandular atypia associated with squamous intraepithelial neoplasia: a premalignant lesion?

Recent studies have described premalignant changes in the endocervical epithelium, but morphological criteria for the diagnosis of cervical glandular atypia of lesser severity than adenocarcinoma in situ have not been established. Adenocarcinoma in situ is often associated with cervical intraepithelial neoplasia (CIN). The endocervical mucosa in 105 cases of CIN grade III was evaluated and compared with that of 100 controls. Sixteen cases of cervical glandular atypia and one case of adenocarcinoma in situ were identified, and it was possible to discriminate between these and a range of benign glandular lesions. Interestingly, the control series included two patients with cervical glandular atypia, one of whom on review had had a cone biopsy for CIN. The progression of cervical glandular atypia through adenocarcinoma in situ to invasive adenocarcinoma is known, but the natural history of cervical glandular atypia is as yet uncertain.

Utilisation of health services by diabetic persons. III: Audit of hospital admissions and bed occupancy

The extent and patterns of use of hospital services by diabetic persons in New Zealand are not well documented. The usage of all four major Canterbury hospitals was prospectively studied for the 12 month period 1 January to 31 December 1983. There were 889 admissions by 689 diabetic persons who were either discharged from or died in hospital within the 12 month survey period (F = 373, M = 316). Ages ranged from three to 95 years mean 64.6 yr (SEM 0.7). One hundred and fifty-one patients were hospitalised more than once. At admission, 63.9% of patients were treated with diet or diet plus oral hypoglycaemic agents, 27.6% with insulin and 8.5% were newly diagnosed. The mean hospital stay was 20.1 (1.1 days), but the longest admission stays were by those over 65 years of age. Overall diabetic persons accounted for 4.8% of the total bed occupancy of the four hospitals. During 1983 14.8% percent of the 1200 insulin treated diabetic persons and 10.2% of the estimated 4000 non-insulin treated diabetic persons in the Canterbury Hospital Board area were hospitalised. Conditions associated with or a consequence of diabetes precipitated 57.5% of admissions. The potentially preventible disorders of glycaemic control and infection were factors in 25% and 26.9% of admissions respectively. These data show high risk of hospitalisation amongst diabetic individuals, particularly for those using insulin, but there is scope for prevention of admission or at least for reduction in duration of hospital stay.

Assessment of dysplasia in colorectal adenomas: an observer variation and morphometric study

Observer variation in the grading of dysplasia in 100 colorectal adenomas has been analysed by kappa statistics. Intraobserver agreement was only 70% and 67% for the two principal observers, and, as would be expected, interobserver agreement was even lower at 59% and 66%. Although the kappa values were significantly different from chance at the 0.1% level, there were substantial disagreements. When the study was extended to four observers, agreement between observer pairings was considerably worse (as low as 34%), and in four pairings the kappa values did not differ significantly from those expected by chance alone even at the 5% level. In an endeavour to improve agreement we adopted a percentage estimation grading method; but this failed to achieve any improvement when comparing overall grades. The percentage estimates of the two observers, however, showed a highly significant correlation. To identify the cytological features given most weight by the principal observers in assessing dysplasia we undertook morphometry on 30 adenomas using an image analysis computer. The nuclear to cytoplasmic ratio, variation in nuclear area, and variation in nuclear height above the basement membrane showed significant differences between mild, moderate, and severely dysplastic epithelia. While evaluation of these parameters therefore appears to be most important in the subjective interpretation of dysplasia, this study has shown that such evaluation is poorly standardised between observers and poorly reproduced within observers. Our findings of poor agreement in the grading of dysplasia in colorectal adenomas has serious implications for the assessment of dysplasia in inflammatory bowel disease, where the added problem of reactive cellular atypia brings greater complexity to these subjective judgments.

Use of health services by diabetic persons. II. Hospital admissions

Over a 10-mo period, a computerized admission discharge system was scrutinized to identify all persons with diabetes mellitus admitted to a general hospital in Christchurch, North Canterbury (population 342,000), New Zealand. The 274 admissions by 197 diabetic persons (42% were insulin treated, 14% were newly diagnosed, 44% were non-insulin-dependent) contributed to 3.6% of the total hospital admissions, with duration of stay being longer than for nondiabetic persons (13.6 versus 11.3 days, P = 0.05). Patients admitted were aged 11-91 yr (mean 59 yr); those over 50 yr of age were numerically the largest admission group. Although cardiovascular illnesses were the most frequent events precipitating admission (34%), potentially preventable admissions for reasons of infection, poor glycemic control, or hypoglycemia were found in all age groups. Just under half of the 902 registered insulin-treated diabetic patients living in this health region had at some stage participated in diabetes education programs at the time this admission survey was undertaken. Of these, only nine were admitted. The other 70 insulin-treated patients admitted who lived in this region had never had diabetes education. Overall, only 11.7% of patients admitted had received diabetes education. These data show that, for insulin-treated diabetic individuals at least, admission rates were substantially lower among those who were sufficiently motivated to attend diabetes education programs.

Malignant Warthin's tumour: an ultrastructural study

Undifferentiated malignant cells in a Warthin's tumour (adenolymphoma) were studied by light and electron microscopy. The ultrastructure of these cells indicated that they were poorly differentiated adenocarcinoma arising from the glandular component of the Warthin's tumour. Some differences between this case and previous ultrastructural studies are described.

Swine microsomal acyl-CoA synthetase activity: effect of age and diet

Fatty acid activation was examined by assessing the activity of acyl-CoA synthetase (ACS) in microsomal fractions of liver and adipose tissue obtained from swine of various ages. Liver ACS activity increased from ca. 200 to 800 nmol/(minute x g tissue) between birth and 25 days postpartum; enzyme activity generally remained elevated postweaning through 155 days of age. The preweaning hepatic patterns on a wet weight and protein basis were similar, but the wet weight- and protein-based patterns diverged after weaning due to an increase in microsomal protein. As in liver, adipose tissue ACS activity rose rapidly from birth to 25 days of age [20-110 nmol/(minute x g tissue)] but declined to lower levels after weaning. Expression of enzyme activity on a wet weight, protein, or cellular basis revealed similar developmental patterns for adipose tissue. The postweaning fall in adipose tissue ACS activity was partially explained by decreasing cellularity per unit tissue weight. In swine fed equal amounts of isoenergetic-isonitrogenous diets with low or high fat content, hepatic ACS activity tended to increase in pigs fed the high fat diet with no effect of diet on the adipose enzyme. Starvation elevated liver ACS activity, whereas the adipose enzyme activity was marginally decreased.

Comparison of ruminant anthelmintics, using multiple dose administration

Eleven ruminant anthelmintics were administered to lambs over a 30-day period, using medicated feeds or multiple oral doses. Fenbendazole and its sulfinyl analog, oxfendazole, were effective (greater than 90%) in the control of clinical parasitism at feeding levels of 5 mg/kg of feed. Parbendazole and albendazole were effective at daily oral dose levels of 1 mg/kg of body weight and at feeding dose levels of 10 mg/kg of feed, respectively. Levamisole, mebendazole, and oxibendazole were ineffective in controlling intense natural parasitic infections of sheep at daily oral dose levels equal to or less than 1 mg/kg of body weight and/or a feeding level equal to or less than 10 mg/kg of feed.

A short-term hospital program preparing borderline and schizophrenic patients for intensive psychotherapy

This paper explores the role of a short-term hospitalization program in preparing certain borderline and schizophrenic patients for intensive psychotherapy on an outpatient basis. I will begin with a description of the inpatient unit and next discuss some relevant theoretical issues regarding borderline and schizophrenic psychopathology. I will then describe how these issues are dealt with in the evaluation procedure, in individual psychotherapy, and in the milieu therapy provided by our program.

Effect of nutritional status on swine adipose tissue lipolytic activities

Young swine (28 days of age) were fed an isocaloric and isonitrogenous diet with either a high fat or a low fat content for 3 to 4 weeks. The adipose tissue lipolytic rate was higher in the group fed the high fat diet. However, there was no effect of diet on the activities of several of the enzymes controlling the lipolytic process, i.e., adenylate cyclase, phosphodiesterase and hormone-sensitive lipase. No effect of diet on the activity of lipoprotein lipase was detected. Fasting for 72 hr, but not for 24 or 48 hr, caused an increase in the lipolytic rate. There was also a decrease in cell size after a 72-hr fast (P greater than .05) such that the increased rate was not significant when the data were expressed on a cell basis. Inexplicable transient changes in adenylate cyclase activity, as well as a decrease in the activity of the low affinity phosphodiesterase (doubtful physiological significance), were detected during starvation. Starvation depressed the adipose tissue lipoprotein lipase activity but had no effect on the hormone-sensitive lipase activity.

Factors influencing the lipogenic rate in swine adipose tissue

Measurements of the lipogenic rate in adipose tissue samples obtained sequentially by biopsy from the same pig may be useful for many nutritional experiments. The average lipogenic rate over a short period (several days to 2 weeks) appears to be relatively stable if the pigs weigh about 20 kg initially and if approximately 10 animals are allotted to each experimental group. The lipogenic rate is readily influenced by the feeding regimen (amount and timing). It is easily lowered by less than ad libitum dietary intakes and is influenced especially by the intake pattern for several days preceding the rate determination. In two different experiments, the lipogenic rate obtained at either 20 or 50 kg body weight was not effective as a predictor of backfat thickness or loineye area measured 13 or 6 weeks later, respectively.

Staff countertransference reactions in the hospital treatment of borderline patients

The aim of this paper is to elucidate a systematic framework for understanding the nature of the borderline patient's reactions to the hospital milieu and for comprehending the responses of hospital staff to such patients. The theory and principles of the therapeutic milieu or milieu therapy are not the focus of this paper; rather, the unique ways in which borderline patients create their own reality and interact with that reality are examined. The borderline patients considered here constitute a group who present severe character pathology, including pronounced distortions in reality testing, marked paranoid trends, minimal distinction between self and others, and multiple hospitalizations that have proven ineffectual. Overall, these patients are functioning at a level more regressed than most borderline patients and their histories often reveal many psychotic episodes. Because of their severe psychopathology, long-term intensive treatment in a hospital setting, termed "reconstructive hospital treatment" by Zee (1975), is indicated. The goal of such treatment is to augment the patient's failing ego functioning, to help the patient develop constructive alternatives for dealing with conflict, and to aid the patient develop constructive alternatives for dealing with conflict, and to aid the patient in embarking upon a psychoanalytically oriented exploration of his highly conflicted object relations. Without the use of the hospital as a treatment modality these patients tend to continue in a downward spiral of destructive relationships. These remarks, therefore, are addressed to the effect severely ill borderline patients have upon the hospital milieu and to the impact of the milieu upon them.

Female expression of the H-2-linked sex-limited protein (Slp) due to non-H-2 genes

Female mice of 15 inbred strains in which males express the H-2-linked sex-limited protein (Slp) were tested for the production of this protein. Four inbred strains (FM, LG/J, NZB, PL/J) were found in which females produce Slp in the absence of hormonal manipulation. Crosses have been made between strains FM, NZB, or PL/J and several Slp-negative strains. Slp-typing of the F1, F2, and backcross progeny, as well as of a number of recombinant inbred strains, indicates that production of Slp by normal females of these strains depends upon the concurrent presence of an Slp-positive, H-2-linked allele and of permissive alleles of one or two non-H-2 autosomal genes. Complementation studies with two of the strains (FM and PL) indicate that an identical genetic mechanism mediates expression of Slp in females of these two strains. FM-derived animals carrying the testicular feminization mutation (tfm) also express Slp, as do castrated NZB mice, indicating that Slp expression in these instances is not dependent upon testosterone as it is in other inbred strains. It is concluded from these results that genes distinct from the putative structural gene for Slp influence the sex-limitation of its expression.

Ontogeny of glycerolipid biosynthetic enzymes in swine liver and adipose tissue

Enzymes associated with glycerolipid biosynthesis were examined in microsomal fractions of liver and adipose tissue obtained from swine of various ages. Generally, liver glycerophosphate acyltransferase, phosphatidate phosphohydrolase, diglyceride acyltransferase, and choline phosphotransferase activities were substantial at birth but increased 2- to 3-fold by day 14 postpartum, decreased at day 25, then increased at the oldest ages studied (up to 155 days postpartum). In adipose tissue, enzyme activities were low at birth and developed through day 25 in a pattern generally similar to that observed in liver. In contrast to liver, the adipose enzymes were depressed immediately postweaning (day 32) with subsequent recovery. The observed decline in adipose tissue enzyme activities expressed on a tissue basis at older ages was primarily the result of increased adipocyte size, since the activities expressed on a cell basis did not decline as rapidly. In both liver and adipose tissue, phosphatidate was the major glycerolipid synthesized by the microsomal glycerophosphate acyltransferase enzymes at all ages (generally greater than 75%). The ratio of neutral lipids to phospholipids produced by acylation of glycerophosphate was increased when a microsomal--cytosolic preparation was used as a source of enzyme in contrast to a microsomal preparation.