Extracellular matrix promotes the growth and differentiation of murine hematopoietic cells in vitro

We have developed a long-term culture system in which murine marrow cells are cultured on a complex extracellular matrix (ECM) that is derived from marrow and extracted with guanidine hydrochloride and dithiothreitol. Marrow cultures were established with fresh murine marrow cells and recharged at 2 wk (week 0). Phase microscopy showed a dramatically increased adherent cell layer development on ECM compared with controls within a week after recharge. By electron microscopy, this adherent layer was composed of numerous reticular cells apparently attached to the ECM which extended cytoplasmic projections to the surrounding hematopoietic cells. Adherent cellularity on ECM-coated dishes increased to 30 times the control values by week 2. Cumulative suspension cells on ECM dishes were eight times controls. ECM influenced both hematopoietic progenitor cell proliferation and differentiation. Adherent colony-forming unit-granulocyte/macrophage and colony-forming unit-megakaryocyte were greater than 30 and 15 times the control values, respectively, by week 2 (P less than or equal to 0.05). There were more mature granulocytic and megakaryocytic cells in ECM-coated dishes than in controls at all time points. This new culture system directly demonstrates that ECM is an important component of the hematopoietic microenvironment.

Lorazepam: a randomized, double-blind, crossover study of a new antiemetic in patients receiving cytotoxic chemotherapy and prochlorperazine

Lorazepam was compared to placebo to assess its control of nausea and vomiting in patients receiving cytotoxic chemotherapy and prochlorperazine. The study design was a randomized, double-blind crossover in which three consecutive chemotherapy courses were compared so that each patient acted as his or her own control. Of 107 patients entered, 80 were evaluable for analysis. Lorazepam significantly reduced the severity and duration of nausea, the severity of vomiting, and the number of vomiting episodes when compared to placebo. Anxiety was reduced during lorazepam courses but not significantly when compared to placebo. There was significantly more sedation with lorazepam courses. Overall, patients preferred lorazepam courses although this preference was significant only in the patient subset receiving doxorubicin and cyclophosphamide. Lorazepam is a useful adjunct to prochlorperazine in patients receiving cytotoxic chemotherapy.

Naltrexone: a short-term treatment for opiate dependence

The narcotic antagonist, naltrexone, was studied in 242 patients during a 6-year period. Although a large number of subjects discontinued naltrexone abruptly, treatment was related to a significant decrease in opiate and nonopiate drug use. Methods for improving retention during induction and maintenance are discussed and posttreatment outcome results are presented. The authors conclude that naltrexone may be a useful short-term treatment option for opiate dependence.

Psychiatric diagnosis of morbidly obese gastric bypass patients

Eighty morbidly obese patients who had had gastric bypass operations were interviewed for psychiatric diagnoses using DSM-III criteria. The lifetime prevalence of Axis I clinical psychiatric diagnoses was 47.5%, with depressive disorders occurring in 28.7% of the total sample. No other diagnosis exceeded a 2.5% prevalence. The authors believe there is no evidence of an increased prevalence of major psychiatric disorder in obese persons when strictly defined diagnostic criteria are used.

The technique and early results of high gastric reduction for obesity

The high gastric reduction operation has been performed on one hundred and nine obese patients over a sixteen-month period. Patient selection, preoperative care, operative technique and postoperative care are described. Our early results show that a satisfactory initial and continuing weight loss can be sustained for a twelve-month period with a low morbidity and mortality. Further follow-up of these patients is required before the ultimate place of this procedure is established.

Effects of contingent payment on compliance with a naltrexone regimen

The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined. Patients were paid under contingencies based on either number of doses ingested or on a fixed time schedule. Reinforcement schedules based on number of doses ingested produced more consistent treatment-oriented behavior than a time-based schedule. Covariation between behavior and alternating contingencies (A-B-A) indicated that the schedules contributed to increased duration of treatment compared to previous noncontingent payment. The issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.

Blood pressure recording in children

Blood pressure levels for 148 children aged 0-14 years were recorded. Two different methods of measurement (the standard sphygmomanometer and the random-zero machine) and two cuffs of varying size were used on each child. Measurements of arm size and pulse rate were taken, and an assessment was made of the emotional state of each child: no association was found between these factors and the recorded measurement of blood pressure. The experiment does however show that: (1) the effect of cuff size can be minimized by using the largest cuff that will fit the child, and then applying a standard correction to the measurement taken; and (2) the random-zero machine is a preferable method of measurement as it reduces observer bias, though measurements taken with a standard and a random-zero machine are not directly comparable.