Does the severity of untreated dental caries of preschool children influence the oral health-related quality of life?

AIM

To assess the impact of untreated dental caries and its severity on the oral health-related quality of life (OHRQoL) of Kuwaiti preschool children and their caregivers.

METHODS

Participants were 4- and 5-year-old kindergarten children attending preselected public schools from one of the Governorates in Kuwait. Early childhood caries (ECC) was evaluated by clinical examinations and presented using decayed, missed, filled teeth/surface (dmft/dmfs). The clinical consequences of untreated dental caries were assessed using the pufa (pulp, ulcers, fistula, abscess) index for primary teeth. A structured questionnaire obtained demographic information of children and their caregivers. OHRQoL was assessed using the Arabic version of Early Childhood Oral Health Impact Scale (A-ECOHIS).

RESULTS

Among the 334 participants, 171 were kindergarten level-1 (KG1), and 163 were level-2 (KG2). The overall prevalence of dental caries was 78.9% for KG1 children and 67.4% for KG2 children. Decayed teeth were the main component for both dmft (84%) and dmfs (68%). The total mean (SD) pufa score was 0.54 (1.5), and about 19.2% of participants had at least one tooth with pufa > 0. A total of 207 A-ECOHIS were completed. Both family and child impact scores were significantly higher for children with a dmft score of 1 or more (p < 0.001) or with one or more pufa (p < 0.001). Child impact section scores were significantly higher with the increasing degrees of untreated caries (dt) (p = 0.004).

CONCLUSION

The severity of untreated dental caries and caries experience had a negative impact on the OHRQoL of Kuwaiti preschool children and their families. Using the pufa index had provided additional information about the effect of the caries severity on the OHRQoL than assessing the caries experience alone.

Phenotypic Assessment of Probiotic and Bacteriocinogenic Efficacy of Indigenous LAB Strains from Human Breast Milk

Breast milk is the combination of bioactive compounds and microflora that promote newborn’s proper growth, gut flora, and immunity. Thus, it is always considered the perfect food for newborns. Amongst their bioactives, probiotic communities—especially lactic acid bacteria (LAB)—are characterized from breast milk over the first month of parturition. In this study, seven LAB were characterized phenotypically and genotypically as Levilactobacillus brevis BDUMBT08 (MT673657), L. gastricus BDUMBT09 (MT774596), L. paracasei BDUMBT10 (MT775430), L. brevis BDUMBT11 (MW785062), L. casei BDUMBT12 (MW785063), L. casei BDUMBT13 (MW785178), and Brevibacillus brevis M2403 (MK371781) from human breast milk. Their tolerance to lysozyme, acid, bile, gastric juice, pancreatic juice, and NaCl and potential for mucoadhesion, auto-aggregation, and co-aggregation with pathogens are of great prominence in forecasting their gut colonizing ability. They proved their safety aspects as they were negative for virulence determinants such as hemolysis and biofilm production. Antibiogram of LAB showed their sensitivity to more than 90% of the antibiotics tested. Amongst seven LAB, three isolates (L. brevis BDUMBT08 and BDUMBT11, and L. gatricus BDUMBT09) proved their bacteriocin producing propensity. Although the seven LAB isolates differed in their behavior, their substantial probiotic properties with safety could be taken as promising probiotics for further studies to prove their in vivo effects, such as health benefits, in humans.

Phenotypic assessment of safety and probiotic potential of native isolates from marine fish Moolgarda seheli towards sustainable aquaculture

Aquaculture is a highly productive and fast-growing agricultural sector. The occurrence of epidemic or sporadic disease outbreak is a major limiting factor in this sector, thus better alternatives are the need of the hour. Use of indigenous probiotics is a promising strategy to control infectious diseases. Thus, the present study was aimed to screen and characterize potent indigenous probiotics from marine fish, Moolgarda seheli, towards enhancing sustainable aquaculture production. Totally 347 bacterial isolates were obtained from M. seheli gastrointestinal tract, out of these, four isolates (KAF121, 124, 135, 136) were confirmed as potent probiotics in terms of biosafety, highly resistant to acidic pH, gastric juice, bile salt, high hydrophobicity to solvents, auto and co-aggregation potential. These four isolates also exhibited virtuous antioxidant activity. Further the isolates, KAF124 and 135 proved their efficiency in growth and survival of fish after challenged againt Aeromonas hydrophila. The isolates were identified based on their 16S rRNA gene sequence and the data were submitted to Genbank as Pseudomonas aeruginosa KAF121 (MH393516), Bacillus cereus KAF124 (MH393226), Bacillus thuringiensis KAF135 (MH393230), and Pseudomonas otitidis KAF136 (MH393230). The results conclude that two isolates, KAF124 and KAF135 are highly safe and potent probiotics which are first time isolated from the marine fish M. seheli. The two Bacillus strains could be used as better alternatives to antibiotics and other chemical-based drugs to prevent/control infectious diseases in aquaculture.

Bacteriocin-a potential antimicrobial peptide towards disrupting and preventing biofilm formation in the clinical and environmental locales

Biofilm, a consortium of microbial cells, protected by extracellular polymeric matrix, is considered a global challenge due to the inherent antibiotic resistance conferred by its lifestyle. Besides, it poses environmental threats causing huge damage in food industries, fisheries, refineries, water systems, pharmaceutical industries, medical industries, etc. Living in a community of microbial populations is most critical in the clinical field, making it responsible for about 80% of severe and chronic microbial diseases. The necessity to find an alternative approach is the need of the hour to solve these crises. So far, many approaches have been attempted to disrupt the initial stage of biofilm formation, including adherence and maturation. Bacteriocins are a group of antimicrobial peptides, produced by bacteria having the potential to disrupt biofilm either by itself or in combination with other drugs than antibiotic counterparts. A clear understanding on mechanisms of bacterial biofilm formation, progression, and resistance will surely lead to the development of innovative, effective biofilm control strategies in pharmaceutical, health care industries and environmental locales.

Effect of Bacillus cereus peptide conjugated with nanoporous silica on inactivation of Listeria monocytogenes in apple juice, as an ecofriendly preservative

Bacteriocins are ribosomally synthesized antimicrobial proteins/peptides. They are of great interest in the food processing industries as potential natural preservative agent to control food-borne pathogens. Bacillus spp. are one among the potential probiotics receiving more attention since they produce a broad spectrum of antimicrobial bioactive peptides. In this study, a small-scale medium composition and bioprocessing parameters were statistically optimized to increase the yield of bacteriocin namely cerein from Bacillus cereus NS02 showing antagonism against a wide range of food-borne pathogens. The cerein was partially purified, characterized, and evaluated for their optimal reaction condition. It was subjected to surface adsorption onto food-grade silica to evaluate its maximal adsorption, reached at 4 h, 40 °C, pH 6-7, and at the initial concentration of 200 AU mL^-1. The effectiveness of silica-adsorbed and silica-free cerein was checked in Listeria monocytogenes inoculated fresh apple juice and demonstrated biopreservative activity. In juice treated with silica-cerein, the colony forming unit (CFU) was found to be less in count on the 15th day of storage at 4 °C whereas, free-cerein was found to contain 3.8 log CFU mL^-1. While, on the same day of storage, the control juice contained the strength of 14.6 log CFU mL^-1. Based on the above, this study concludes that the identified heat stable low molecular weight peptide cerein from B. cereus NS02 could serve as a potential biopreservative with effective antilisterial activity in the food system. However, a more detailed study is required to determine if their quality change especially the effect of cerein in organoleptic and nutritional properties of food beyond their addition is necessary, before it is to be exploited as an ecofriendly biopreservative.

Measurement of Apolipoprotein B May Predict Acute Coronary Syndrome in Hyper-triglyceridemic Young Population

The purpose of this study is to measure apolipoprotein B (ApoB) in hyper-triglyceridemic (HTG) young people of Bangladesh for predicting risk of acute coronary syndrome. This case-control study was carried out in Department of Cardiology, of Mymensingh Medical College Hospital within the period from June 2009 to May 2010. A total 50 case of 18-45 years of age with first attack of acute coronary syndrome admitted in coronary care unit and 50 healthy controls of same age and sex distribution were studied. Twenty (40%) of the studied case and 21(42%) of controls had hyper hyper-triglyceridemia, of those 18(90%) of HTG cases and 12(57.1%) of HTG controls had hyper-ApoB condition. The present study shows significant association of apolipoprotein B as an independent determinant and estimation of ApoB may be an alternative tool for predicting risk of development of acute coronary syndrome in hyper-triglyceridemic young people.

Association of hypoglycemia, hypocalcemia and hypomagnesemia in neonates with perinatal asphyxia

The clinical evidence of neurological menifestations associated with asphyxia is described as hypoxic ischaemic encephalopathy (HIE). A variety of metabolic problems are present in asphyxiated newborns including hypoglycemia, hypocalcemia, hypomagnesemia and others metabolic abnormalities. Some of these biochemical disturbances may trigger seizure or potentiate further brain damage. This cross sectional case-control study was done in Mymensingh Medical College Hospital, to identify the association of hypoglycemia, hypocalcemia, hypomagnesemia in neonates with perinatal asphyxia. Study period was six months. Sample size was 60. Among total sample 30 term asphyxiated newborns of <24 hours age were case and equal number term healthy newborns <24 hours age were control. The main clinical presentations were delayed cry after birth along with respiratory distress, convulsion and absence of cry in asphyxiated newborns. Major physical findings were cyanosis, convulsion and tachypnoea in asphyxiated group. The mean value of serum calcium level was significantly lower in asphyxiated newborns (7.37 ± 0.10mg/dl) than control value (8.04±0.09mg/dl). Hypocalcemia was found among 23.33% babies in case group. On the contrary, hypocalcemia was found in single baby among control group. The mean value of serum magnesium was significantly lower in asphyxiated newborns (1.83 ± 0.04mg/dl) than control value (1.96 ± 0.05mg/dl). Hypomagnesemia was found among 3(10%) newborns but none was found among control group. Hypoglycemia was found in 7(23.33%) cases though the mean value of blood glucose was higher in case group (5.72 ± 0.62mmol/l) than control group (4.87 ± 0.15mmol/l) difference was not statistically significant. Combined hypoglycemia, hypocalcemia and hypomagnesemia were found in 1(3.33%) case; combined hypoglycemia and hypocalcemia were found in 2(6.67%) cases; and combined hypocalcemia and hypomagnesemia were found in 1(3.33%) case. During the study period, 3(10.0%) cases were expired but no death occurred among control group. This study shows isolated or combined hypoglycemia, hypocalcemia, hypomagnesemia are frequently found in newborns with perinatal asphyxia. So, it is necessary to monitor blood glucose, serum calcium and also serum magnesium among asphyxiated newborns for proper management.

Serum magnesium status among acute myocardial infarction patients in Bangladesh

This case control cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with Cardiology Department of Mymensingh Medical College Hospital, Mymensingh during the period of July 2004 to June 2005. The aim of the study was to explore the status of serum magnesium among acute myocardial infarction (AMI) patients as a means to monitor the possibility of management of these patients. A total of 100 subjects were selected and were grouped as Group I (50 healthy control subjects) and Group II (50 subjects of AMI Cases). Serum magnesium was estimated by colorimetric method from each sample. Statistical analysis was done by using SPSS windows package. Among the groups, mean±SD (Standard Deviation) of Group I and Group II serum magnesium were 2.16±0.25 and 1.71±0.17mg/dl respectively. By comparing Group I with Group II highly significant difference were found in case of serum magnesium (p<0.001). It is evident from the study that serum magnesium level significantly decreases among acute myocardial infarction patients in Bangladesh.

Studies on serum LDL-cholesterol in second and third trimester of pregnancy

The present study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh during the period of July 2006 to June 2007 to evaluate the effect of pregnancy on serum LDL-cholesterol. The serum concentrations of LDL-cholesterol was measured in 100cases during their 2nd and 3rd trimester of pregnancy and in a control group of 100 cases of non pregnant women which was matched on reproductive age. Data were analyzed by computer with SPSS program using unpaired student 't' test. The result showed that the pregnant women had significantly higher concentrations of serum LDL-cholesterol. Higher concentrations of serum LDL-cholesterol was more common in pregnant than control and reaching maximum at 3rd trimester of pregnancy. This may be a purely physiological response to pregnancy or it may be indicative of pathology in some women. These results warrant a follow up study to investigative whether the LDL hypercholesterolemia persists after parturition.

Lipid profile changes in second trimester of pregnancy

The present study was carried out in the department of physiology, Mymensingh Medical College, Mymensingh, Bangladesh during the period of July 2006 to June 2007. The aim of the study was to investigate the changes in serum total cholesterol, triacylglycerol, HDL-cholesterol and LDL-cholesterol during the 2nd trimester of normal pregnancy. The serum concentrations of total cholesterol, triacylglycerol, HDL-cholesterol and LDL-cholesterol were measured in 50 cases during the second trimester of pregnancy and in a control group of 100 cases of non pregnant women, which was matched on reproductive age. Data were analyzed by computer with SPSS program using unpaired 't' test. The result showed that the pregnant women had significantly higher concentrations of serum total cholesterol, triacylglycerol and LDL cholesterol (p<0.001). But in case of HDL-cholesterol the mean concentration was slightly higher than control group though not statistically significant (p<0.079). Higher concentration of lipids and lipoproteins in second trimester of pregnancy may be a purely physiological response to pregnancy or it may be indicative of pathology in some women. These results warrant a follow up study to investigate whether the hyperlipidaemic response to pregnancy is variable and if so, whether it can predict future hyperlipidaemia in later life.

Use of anaesthetic rooms in obstetric anaesthesia; a postal survey of obstetric anaesthetists and departments in the United Kingdom

BACKGROUND

Use of anaesthetic rooms has been much discussed in the UK in recent years, but attitudes and practices of obstetric anaesthetists regarding their use for caesarean section have never been sought.

METHOD

A postal survey was conducted to discover the extent of use of anaesthetic rooms versus operating theatre for induction of anaesthesia and reasons for using or not using them. Questionnaires regarding individual practices were sent to 400 randomly selected members of the Obstetric Anaesthetists' Association ( approximately 25% of UK membership). Questionnaires regarding departmental policies were sent to 100 "clinicians responsible for surveys" (approximately 38% of departments providing obstetric anaesthesia in the UK).

RESULTS

For elective caesarean section, 70% of individual clinicians never used an anaesthetic room, 9% rarely, 5% usually, 9% for all regional anaesthetics and 6% always. For emergency caesarean section the corresponding figures were 83%, 5%, 5%, 3% and 2% respectively. Use of the anaesthetic room was independent of the seniority of anaesthetists. In 68% of departments it was standard practice or policy to induce all anaesthetics for caesarean section in the operating room. Conversely, only 1% of departments had a policy to induce all anaesthetics in the anaesthetic room. Patient safety was the usual reason given for anaesthetising in the operating room.

CONCLUSION

The majority of obstetric anaesthetists have abandoned the use of anaesthetic induction rooms, the main reason being patient safety. For the same reason, two-thirds of departments providing obstetric anaesthesia consider induction of anaesthesia in the operating room their standard practice.

An Analysis of Public Expenditure on Education in Pakistan

Achieving economic growth is an important goal of any country. However, in recent years it has increasingly been realised that economic growth is a necessary but not a sufficient condition for human development. Pakistan provides a good example of a country which has historically enjoyed a respectable GDP growth rate and yet failed to translate this positive development into a satisfactory level of human development. Since its independence in 1947, Pakistan’s development policies have focused primarily on realising high economic growth and only incidentally on the task of providing social necessities. Such a process has given rise to a structure of production and distribution which has been only indirectly responsive to social goals. However, there is now a growing realisation that we could have done much better had we stressed human resource investments relatively more. The Education For All (EFA) movement, started more than a decade ago in 1990, accelerated the process of human resource development in many developing countries. The EFA refers to the global commitment to ensure that all children would complete Primary Education of good quality. A decade after, the Millennium Declaration resolved to ensure, by 2015, that all children would be able to complete a course of primary education.

K(+) transport in red blood cells from human umbilical cord

The current study was designed to characterise K(+) transport in human fetal red blood cells, containing mainly haemoglobin F (HbF, and termed HbF cells), isolated from umbilical cords following normal parturition. Na(+)/K(+) pump activity was comparable to that in normal adult human red cells (which contain HbA, and are termed HbA cells). Passive (ouabain-resistant) K(+) transport was dominated by a bumetanide (10 microM)-resistant component, inhibited by [(dihydroxyindenyl)oxy]alkanoic acid (100 microM), calyculin A (100 nM) and Cl(-) removal, and stimulated by N-ethylmaleimide (1 mM) and staurosporine (2 microM) - all consistent with mediation via the K(+)-Cl(-) cotransporter (KCC). KCC activity in HbF cells was also O(2)-dependent and stimulated by swelling and urea, and showed a biphasic response to changes in external pH. Peak activity of KCC in HbF cells was about 3-fold that in HbA cells. These characteristics are qualitatively similar to those observed in HbA cells, notwithstanding the different conditions experienced by HbF cells in vivo, and the presence of HbF rather than HbA. KCC in HbF cells has a higher total capacity, but when measured at the ambient PO(2) of fetal blood it would be similar in magnitude to that in fully oxygenated HbA cells, and about that required to balance K(+) accumulation via the Na(+)/K(+) pump. These findings are relevant to the mechanism by which O(2) regulates membrane transporters in red blood cells, and to the strategy of promoting HbF synthesis as a therapy for patients with sickle cell disease.

Regulation of multidrug resistance gene mdr1b/mdr1 expression in isolated mouse uterine epithelial cells

The mammalian uterine epithelium (UE) undergoes drastic physiological and morphological changes during pregnancy. Steady-state levels of murine mdr1b mRNA, transcribed from a multidrug resistance gene encoding a membrane protein which functions as a transporter of lipophilic cytotoxic agents, are low in nonpregnant, cycling UE, but drastically increase (about 1,500- to 2,000-fold) at day 8 of gestation. At day 16 of gestation, levels of mdr1b mRNA are 2,500- to 3,000-fold higher than those in the cycling UE cells. Levels of mdr1b mRNA were elevated to levels comparable to those observed during pregnancy, in the UE of ovariectomized mice following 5-8 days of estrogen and progesterone administration. Withdrawal of these hormones resulted in a drastic reduction of mdr1b mRNA within 36 hr. These results suggested that steroid hormones alone can account for increased mdr1b mRNA expression and do not require the presence of other placenta/embryo-derived factors. Moreover, the hormonal effect on uterine mdr1b mRNA biosynthesis during pregnancy apparently is a delayed phenomenon. Nuclear run-on assays demonstrated that the rate of mdr1b transcription in UE cells prepared from 15-day pregnant mice (d-15 UE cells) was about two- to three-fold higher than that in nonpregnant UE cells. This increased transcription rate alone cannot account for mdr1b mRNA accumulation during pregnancy. mdr1b mRNA expression was investigated in primary cultures of d-15 UE cells. mdr1b mRNA levels decayed by 50% within 3-4 hr of culture and reached a steady-state 0.5-2% of initial levels by 24 hr. The rate of mdr1b mRNA decay in primary d-15 UE cells was decreased by treatment with alpha-amanitin or cycloheximide, suggesting that the decay pathway requires both transcription and de novo protein synthesis. Our results suggest that multiple mechanisms are involved in the maintenance of the high levels of mdr1b mRNA in pregnant UE cells. Furthermore, these data suggest that increased mRNA stability may contribute to the accumulation of mdr1b transcript during pregnancy.

Retroviral delivery of DNA into the livers of transgenic mice bearing premalignant and malignant hepatocellular carcinomas

To develop gene therapy for hepatocellular carcinoma (HCC), we infused mice through the portal vein with retrovirus carrying the Escherichia coli beta-galactosidase reporter gene under the transcriptional control of the viral long terminal repeat (LTR) and the promoter from the mouse multidrug resistance gene mdr1b. Two transgenic mouse HCC models were used, one bearing the human hepatitis B viral envelope protein and the other SV40 T antigen. These animals develop HCC with predictable pathological manifestations. The viral transduction efficiency appeared to depend upon the stage of the disease in the animals. The most efficient transduction occurred when the livers had developed microscopic nodular hyperplasia; in some cases as many as 0.01-0.1 copies/cell were transduced. The transduction efficiency was lower in the late stage of the disease when livers had a heavy tumor burden and in the early stage when no lesion was evident. Low viral transduction efficacy was also seen in nontransgenic animals but was significantly increased by partial hepatectomy. The expression of the reporter gene in these animals was very low, as determined by histological staining. These results suggest that hepatocarcinogenesis can enhance retroviral delivery of foreign genes into the liver. Further development by increasing the viral transducing efficiency and the level of expression of transduced gene is required.

Central pontine myelinolysis as a manifestation of the paraneoplastic syndrome

We have described a patient who had lung carcinoma, syndrome of inappropriate antidiuretic hormone, and central pontine myelinolysis (CPM). Although this association is well-known, it appears to be the first report having radiographic documentation of both the intracranial and intrathoracic abnormalities. When searching for the cause of CPM, the possibility of an underlying malignancy should also be considered. This may be more common than the radiology literature would suggest.

Extramammary Paget's disease of the vulva with dermal invasion and vulval intra-epithelial neoplasia

Vulval biopsies from a 66-year-old lady complaining of pruritus showed intraepithelial Paget's disease. On simple vulvectomy, extramammary Paget's disease was found to be associated with vulval intra-epithelial neoplasia (VIN III) and superficial dermal invasive adenocarcinoma. Bilateral inguinal lymphadenectomy later revealed metastatic spread of the tumour. We believe this is a unique combination and discuss the possible origins in relation to this lady's past medical history of breast carcinoma 20 years and spinal metastases 17 years before.

Occurrence of invasive thymoma after thymectomy for myasthenia gravis: report of a case

We report the occurrence of an invasive thymoma following a median sternotomy with removal of a normal involuted thymus in a patient with myasthenia gravis and stress the prompt reevaluation of post-thymectomy patients who have an initial good response and then deteriorate.

Herpes zoster myelitis occurring during treatment for systemic lupus erythematosus

A 15-year-old girl with systemic lupus erythematosus suddenly developed fever, meningismus, and herpes zoster. Within 48 hours, transverse myelitis developed at the level of the nerve root involvement of the herpes zoster. Since both systemic lupus erythematosus and varicella-zoster have been reported to cause myelitis, therapy was initiated for both. The rapid and simultaneous resolution of both the herpes zoster and the neurologic deficits strongly supports the causal association of both with varicella-zoster. This is the second reported case of herpes zoster-associated transverse myelitis in a patient with systemic lupus erythematosus.

Concurrence of limb girdle muscular dystrophy and myasthenia gravis

We describe a case of limb girdle muscular dystrophy with associated myasthenia gravis. This association has not been previously noted in the literature. The unusual feature of the case was that symptoms coexisted for several years before a correct diagnosis was made. The diagnosis was based on the clinical picture and the results of the muscle biopsy and electrophysiologic testing. This case serves to illustrate the fact that a separate problem should be considered when the clinical picture is not compatible with the underlying diagnosis.

Intrathecally administered natural human fibroblast interferon reduces exacerbations of multiple sclerosis. Results of a multicenter, double-blind study

A randomized, double-blinded, placebo-controlled, two-year multicenter study demonstrated that natural human fibroblast interferon (interferon beta) administered intrathecally (IT) is effective in reducing the exacerbations of exacerbating-remitting multiple sclerosis (MS). The mean reduction in exacerbation rate of 34 patients with MS who received interferon beta administered IT was significantly greater during the study than that of 35 control patients who received placebo. The prestudy exacerbation rates were comparable for both patients who received interferon beta and control patients, but the exacerbation rate of patients receiving interferon beta at the end of the study was significantly lower than that of the control patients. Interferon beta was administered by nine or ten lumbar punctures for the first six months of the study, and observations were continued for two years. In 95% of the recipients, interferon beta therapy was well tolerated, and the side effects experienced were clearly acceptable for the benefits achieved. Low doses of indomethacin dramatically reduced the toxicity of interferon beta therapy and played an important role in successful double blinding. This study confirms a preliminary report on 20 patients that initially suggested that interferon beta administered IT was of benefit in patients with MS. The number of treatments was fewer and the dosage of interferon beta administered was less in the present study than in the preliminary one. It is possible that even fewer treatments with lower doses of interferon beta administered might provide a similar degree of prophylaxis against exacerbations.

Multicentre double-blind study of effect of intrathecally administered natural human fibroblast interferon on exacerbations of multiple sclerosis

In this randomised, double-blind, placebo-controlled, 2-year multicentre study intrathecally administered natural human fibroblast interferon (IFN-B) was effective in reducing exacerbations of multiple sclerosis (MS) in patients with exacerbating/remitting disease. The mean reduction in exacerbation rate of 34 patients who received IFN-B (recipients) was significantly greater during the study than that of 35 patients who received placebo (p less than 0.04). The prestudy exacerbation rates were comparable in recipients and controls, but the rate at the end of the study was significantly lower in recipients than in controls (p less than 0.001). IFN-B was given by nine or ten lumbar punctures over the first 6 months of the study, and patient observations continued for 2 years. IFN-B was well tolerated in 95% of the recipients, and the side-effects experienced were clearly acceptable for the benefits achieved. Low doses of indomethacin reduced the toxicity of IFN-B and played an important role in successful double-blinding.

Peripheral dystonia

We studied four patients with distal, action-induced involuntary postures of the hand that could be considered focal dystonia. All four patients had electrophysiologic findings consistent with peripheral nervous system lesions (pronator teres syndrome, radial nerve palsy, lower brachial plexus lesion, or median nerve lesion). With varying success, patients were treated with carbamazepine, trihexyphenidyl, methocarbamol, and wrist splinting. We wish to emphasize that peripheral entrapment and brachial plexopathy should be added to the causes of secondary dystonias.

Enhancement of [3H-methyl]thymidine incorporation and replication of rat chondrocytes grown in tissue culture by plasma, tissue extracts and vasopressin

A pituitary mitogenic peptide, which stimulates cellular replication of a variety of cells maintained in tissue culture, has been identified by other investigators. To study this mitogenic substance, we developed an assay to measure mitogenic substances utilizing fetal rat chondrocytes grown in monolayer culture. Mitogenic activity of added test substances was determined by [3H-methyl]thymidine incorporation into trichloroacetic acid insoluble cell products and increase in total cell number after 24 h exposure. Extracts of whole pituitary glands were more potent in stimulating these cellular indices than either those of liver or muscle, confirming that the chondrocytes are sensitive to the described mitogen. Identically prepared extracts of either anterior or posterior pituitary lobes were mitogenic indicating the presence of two or more mitogenic substances in crude pituitary extracts. Synthetic lysine vasopressin and a beef pitressin concentrate stimulated thymidine incorporation into chondrocytes in the absence of calf serum and this effect was additive to that of calf serum, suggesting that the mitogenic substance of posterior pituitary extracts was vasopressin. The maximum effective dose of vasopressin leading to an increase in either thymidine incorporation or total cell number was between 100 to 500 pg/ml, and as little as 50 pg/ml of hormone elicited an increase in total cell number. The mitogenic effect of both vasopressin and calf serum on chondrocytes was partially inhibited by 1 X 10(-4)M N, O'dibutryl cyclic adenosine 3',5' monophosphate suggesting that cell division of chrondrocytes may be under tonic control by the andenylyl cyclase system. We conclude that vasopressin is a potent mitogen for chondrocytes maintained in tissue culture and its presence must be rigorously excluded in evaluating mitogenic activity of pituitary or serum concentrates.