Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

The impact of risk on preference values: implications for evaluations of postmenopausal osteoporosis therapy

OBJECTIVE

The objective was to assess the impact of different levels of risk of disease on a woman's preferences for health states. Women were provided with health scenarios incorporating different levels of lifetime risks for breast cancer, hip fracture, and coronary heart disease (CHD). In this way, we were able to determine the incremental effect of changes in risks of each disease on preference values.

METHODS AND DATA

Preference values and utility scores were obtained for six health scenarios by both the feeling thermometer (FT) and standard gamble (SG) methods. Scenarios presented the different lifetime risks of CHD, breast cancer, and hip fracture associated with and not associated with long-term use of hormone replacement therapy (HRT) and raloxifene. Risks of breast cancer were based on perceived risks and population risks. The sample population consisted of 40 healthy female volunteers aged between 45 and 65 years randomly selected from the Ottawa-Carleton district.

RESULTS

Based on their perceived risk of breast cancer, the women had higher value scores for the raloxifene risk profile than for both HRT (p = .002) and no therapy (p = .003), with similar results for analyses based on population risks and from utility scores. Regression analysis showed that the risk of breast cancer (p < .001) was the only disease risk that was statistically significantly associated with women's preferences.

CONCLUSIONS

Women had significant preferences over the different risk profiles, primarily due to the incremental effect on changes in values for the risk of breast cancer. Therefore, studies evaluating therapies for osteoporosis should consider patient preferences for living with different risk profiles.

Percutaneous removal of a large mobile right atrial thrombus using a basket retrieval device

This report documents the removal of a large mobile serpiginous right atrial thrombus using percutaneous intravascular techniques with fluoroscopic and transesophageal echocardiographic guidance. Technical aspects and potential complications are discussed.

A human anti-HIV autoantibody enhances EBV transformation and HIV infection

A highly specific, human IgG mAb, F223, which reacts with both HIV-1-infected cells and uninfected lymphoid cells, has been derived. F223 reacts with gp120 but fails to neutralize viral infection. The antibody does enhance HIV-1 infection in a complement-dependent manner. The autoantigen recognized by F223 is expressed on a small percentage of T cells and NK cells and the majority of B cells. Immunoprecipitation demonstrates F223 reactivity with an as of yet unidentified 159-kDa protein in uninfected lymphoid cells. This reactivity with uninfected cells is inhibited by free gp120 demonstrating the cross-reactive nature of this antibody. The F223 light chain demonstrates strong homology to VLlambda2 family genes whereas the heavy chain is most homologous (84%) to the germline gene VH3-H.11. In vivo usage of VH3 family genes by F223 and an anti-HIV-1 (gp41) human mAb, 3D6, with related autoreactivity, suggests that VH3 sequences may be important components of potentially pathogenic human anti-HIV-1 envelope autoantibodies. F223 was isolated from an HIV-1 infected individual with lymphoma and in vitro F223 significantly enhances EBV transformation of normal B cells and increases immunoglobulin production without affecting B cell proliferation. Characterization of this antibody response may provide important insights and mechanistic information on HIV pathogenesis.

Lack of association between acquisition of TT virus and risk behavior for HIV and HCV infection in Vietnam

BACKGROUND

The search for the cause of chronic hepatitis among individuals with non-A to G hepatitis has led to the discovery of a post-transfusion hepatitis-related DNA virus, designated TT virus (TTV), which, based on viral sequences, belongs to a new virus family. The principal modes of infection with TTV are poorly understood, and its role in human immunodeficiency virus type 1 (HIV-1) infection is unclear.

OBJECTIVE

To determine if injection drug use (IDU) and high-risk heterosexual activity (HRHA), principal modes of acquiring HIV-1 infection, place individuals at greater risk of acquiring TTV.

METHODS

The authors analyzed DNA, extracted from sera or filter paper-blotted whole blood, obtained during August 1997 and June 1998 from 324 Vietnamese (148 male; 176 female), for TTV sequences by hot-start, heminested polymerase chain reaction.

RESULTS

Prevalence of TTV viremia was similar among individuals engaging in IDU or HRHA (23.4% vs. 20.2%; P > 0.5), with no age- or gender-specific differences. No association was found between TTV viremia and co-infection with HIV-1 or hepatitis C virus (HCV). Phylogenetic analysis of 30 TTV sequences revealed two distinct genotypes and four subtypes that did not segregate according to gender, HIV-1 and HCV risk behaviors, or geographic residence.

CONCLUSIONS

Among HIV-1- or HCV-infected Vietnamese, who presumably acquired their infection by either the parenteral or nonparenteral route, the data indicate no clear association between acquisition of TTV infection and risk behavior for HIV-1 or HCV infection, suggesting that the usual route of TTV transmission in Vietnam is other than parenteral or sexual.

Minimal incidence of serum antibodies reactive with intact primary isolate virions in human immunodeficiency virus type 1-infected individuals

Immunoglobulin G reactive with primary isolate virions was detected in 36% of serum samples from individuals infected with human immunodeficiency virus type 1. Of these individuals, serum samples from only 7% captured significant quantities of virus. Virion-specific antibody correlated with CD4 counts and, of more significance, primary isolate neutralization. Further dissection of this response should lead to the identification of antibodies and antigenic epitopes for vaccine purposes.

Gradual loss of IgG antibodies against GB virus C/hepatitis G virus in a patient with AIDS

GB virus C/hepatitis G virus (GBV-C/HGV) is a positive-sense, single-stranded RNA virus belonging to the family Flaviviridae and is distantly related to hepatitis C virus (HCV). GBV-C/HGV can be transmitted by the parenteral and the sexual route. Among individuals infected with human immunodeficiency virus type 1 (HIV-1) by the sexual route, we and others have demonstrated a high prevalence of GBV-C/HGV infection. Recently, Woolley and colleagues reported that AIDS patients co-infected with GBV-C/HGV had a significantly lower mean CD4 cell count than AIDS patients without GBV-C/HGV infection, suggesting that GBV-C/HGV antibody may be lost with progression to AIDS. To our knowledge no data are available on the loss of antibody against GBV-C/HGV in AIDS patients. We now report on an HIV-infected patient who exhibited gradual loss of IgG antibodies against GBV-C/HGV, as well as HCV, with progression of HIV disease.

Inversion-recovery echo-planar MR in adult brain neoplasia

PURPOSE

A T1-weighted multishot inversion-recovery (IR) echo-planar MR imaging (EPI) sequence was developed to improve intracranial tissue differentiation; its diagnostic utility was compared with that of conventional axial T1-weighted spin-echo and axial T2-weighted turbo spin-echo sequences.

METHODS

Eighteen patients with known or suspected primary or metastatic brain neoplasia were imaged in a 1.5-T unit with IR-EPI sequences. Three observers measured gray/white matter contrast-to-noise ratios and subjectively compared IR-EPI sequences with T1-weighted spin-echo and T2-weighted turbo spin-echo sequences for gray/white matter discrimination, visibility of intracranial and vascular structures, overall lesion conspicuity, size of lesion(s), and presence and severity of artifacts.

RESULTS

Twenty-four lesions (including neoplasia, infarction, treatment-associated encephalomalacia, nonneoplastic white matter signal abnormalities, and basilar artery dolichoectasia) were detected in 12 patients. Basilar artery dolichoectasia was not included in subsequent statistical analysis. Pulsatile flow artifacts were markedly reduced on IR-EPI sequences relative to those on T1-weighted spin-echo sequences. Gray/white matter contrast was greater on IR-EPI images than on T1-weighted spin-echo images. Periaqueductal gray matter, basal ganglia, optic tracts, cranial nerve V, and claustrum were seen better or as well on IR-EPI images as compared with T1-weighted spin-echo images. IR-EPI was more sensitive to magnetic sensitivity effects, with resultant decreased visibility of cranial nerves VII and VIII and the orbital portion of the optic nerves. For noncontrast sequences, lesion conspicuity was better on IR-EPI images than on T1-weighted spin-echo images in 16 (70%) of 23 lesions and was equal on the two sequences in seven (30%) of 23 lesions. Lesion size, including surrounding edema, was greater on IR-EPI images than on T2-weighted turbo spin-echo images in two (9%) of 23 cases and equal in 21 (91%) of 23 cases. Hyperintense foci of methemoglobin were more conspicuous on T1-weighted spin-echo images.

CONCLUSION

Multishot IR-EPI is superior to conventional T1-weighted spin-echo imaging for parenchymal tissue contrast and lesion conspicuity, and is equal to T2-weighted turbo spin-echo imaging in sensitivity to pathologic entities.

Src phosphorylates the insulin-like growth factor type I receptor on the autophosphorylation sites. Requirement for transformation by src

The insulin-like growth factor type I (IGF-I) receptor can become tyrosine phosphorylated and enzymatically activated either in response to ligand or because of the activity of the Src tyrosine kinase (Peterson, J. E., Jelinek, T., Kaleko, M., Siddle, K., and Weber, M. J. (1994) J. Biol. Chem. 269, 27315-27321). The goal of the present study was to analyze the mechanistic basis and functional significance of the Src-induced phosphorylation and activation of the IGF-I receptor. 1) We mapped the sites of IGF-I receptor autophosphorylation to peptides representing three different receptor domains: tyrosines 943 and 950 in the juxtamembrane region; tyrosines 1131, 1135, and 1136 within the kinase domain; and tyrosine 1316 in the carboxyl-terminal domain. The juxtamembrane and kinase-domain peptides were phosphorylated both in vivo and in vitro. The carboxyl-terminal site, although phosphorylated in vitro and in src-transformed cells, was not a major site of ligand-induced phosphorylation in vivo. 2) We determined that the sites of Src-induced phosphorylation of the IGF-I receptor are the same as the ligand-induced autophosphorylation sites and that the Src kinase can catalyze these phosphorylations directly. 3) We showed that cells cultured from mice in which the IGF-I receptor has been knocked out by homologous recombination are defective for morphological transformation by src. Thus, the Src kinase can substitute for the receptor kinase in phosphorylating and activating the IGF-I receptor, and this receptor phosphorylation and activation are essential for transformation by src.

Three-dimensional diagnosis and management of Class II malocclusion in the mixed dentition

Class II malocclusion is a commonly observed problem, occurring in about one third of the United States population. The numerous treatment approaches that have been advocated to treat this malocclusion presumably produce differing treatment effects within the skeletal, dentoalveolar, and soft tissue components of the face. In the first section of this article, the three-dimensional components of Class II malocclusion are described, with transverse maxillary discrepancy, mandibular skeletal retrusion, and increased lower anterior facial height observed as common findings in a mixed dentition sample of Class II subjects. Second, the literature concerning two seemingly diverse treatment methods (extraoral traction and functional jaw orthopedics) is reviewed in detail. Last, cephalometric data are presented from a retrospective clinical study and is used to evaluate the treatment effects produced by cervical traction and the FR-2 appliance of Fränkel in comparison with an untreated sample of mixed dentition Class II patients. The results of this study indicated that although both skeletal and dentoalveolar components of Class II, Division 1 malocclusion were altered in the Class I direction by either a facebow or a Fränkel appliance, these two appliance systems accomplished the correction in dramatically differing ways. Cervical traction affected the skeletal and dentoalveolar components of the maxilla and mandible, whereas the FR-2 appliance had less of an effect on maxillary and dentoalveolar components and a greater effect on mandibular length. Thus, these two treatment modalities produce decidedly different treatment effects in patients with Class II malocclusions.

Optimization of radiation dose and image quality in mammography: a clinical evaluation of rhodium versus molybdenum

Mammography was done with a conventional molybdenum anode/filter combination and either a molybdenum/rhodium (Mo/Rh) or rhodium/rhodium (Rh/Rh) combination to compare the contrast characteristics and penetrating ability of the different techniques. Each pair was rated as being equal, one slightly better than the other, or one much better than the other. The "preferred" image was also selected. The entrance surface exposure and the mean glandular dose were determined for each exposure. Mo/Mo was compared with Mo/Rh in 26 patients and to Rh/Rh in 23. Mo/Mo was judged to produce better or equal contrast and penetration in all cases except one using the Mo/Rh combination. Mo/Rh was the preferred image only once and Rh/Rh not at all. In comparison to the conventional Mo/Mo technique, the average dose was reduced by approximately 25% with Mo/Rh and by 50% with Rh/Rh.

Permanent testicular damage induced in rats by a single dose of tunicamycin

Tunicamycin administered as a single subcutaneous dose of 200 micrograms/kg caused permanent destruction of seminiferous tubules in adult male rats. The fertility of females was unimpaired by doses of up to 450 micrograms/kg. Degenerative changes in seminiferous tubule epithelium commenced 3 to 5 days after injection and by day 19 affected 95% of tubule profiles in sections. In 95% of tubules only Sertoli cells survived to day 56. Tubules without any surviving cells were present from day 19 and slowly increased in number, a variable proportion becoming mineralised. No regeneration occurred within one year. Leydig cells became more prominent because of the atrophy of seminiferous tubules, but their total mass did not differ significantly from that of control rats, nor did the plasma concentration of testosterone. Changes in tissues other than the tests were transient. The testicular damage seems to have resulted from localised ischaemia caused by tunicamycin-induced vasoconstriction.

c phosphorylation and activation of the IGF-I receptor in src-transformed cells

Using a panel of src mutants partially defective for malignant transformation, our laboratory has previously identified the insulin-like growth factor (IGF-I) receptor as a protein whose tyrosine phosphorylation correlates with transformation by src in embryonic chick cells (Kozma et al., 1990; Kozma and Weber, 1990). It has not been clear, however, whether src-induced phosphorylation altered the enzymatic or signaling properties of the IGF-I receptor and thus whether the IGF-I receptor could be a functionally significant target for pp60v-src. To examine the effect of src expression on the activity of the IGF-I receptor, the human IGF-I receptor was expressed in Rat-1 fibroblasts co-expressing the temperature-sensitive v-src mutant, tsLA29. The IGF-I receptor exhibited an elevated level of tyrosine phosphorylation in src transformed cells even in the absence of IGF-I treatment. Increased receptor phosphorylation occurred rapidly when cells expressing a temperature-conditional src mutant were shifted from the restrictive to the permissive temperature. Src-induced phosphorylation of the receptor was correlated with an increase in the in vitro tyrosine kinase activity of the receptor, both toward itself and exogenous substrates. The src-induced increase in receptor activity was shown to be dependent on tyrosine phosphorylation, as treatment with a tyrosine-specific phosphatase lowered receptor activity. A kinase-defective mutant of the IGF-I receptor also became constitutively phosphorylated in src-transformed cells, ruling out a possible autocrine mechanism for this phosphorylation. Collectively these data indicate that pp60v-src induces ligand-independent phosphorylation and activation of the IGF-I receptor by an intracellular mechanism, consistent with the possibility that receptor phosphorylation could contribute to the genesis of the transformed phenotype.

Prevalence of hypertrophic cardiomyopathy in an outpatient population referred for echocardiographic study

Although hypertrophic cardiomyopathy (HC) is believed to be a relatively uncommon cardiac disease, the frequency with which it occurs in the general or cardiac population has not been defined. To address this issue, the patient population of a community-based echocardiography laboratory was used to assess the prevalence of HC in 714 consecutively studied outpatients with (or suspected of having) heart disease. The most common cardiac disease identified was mitral valve prolapse (73 patients [10%]), and HC was present in 4 patients (0.5%). Ages were 50 to 69 years. Maximal left ventricular wall thicknessess were 15 to 22 mm (mean 19); only 1 had evidence of obstruction to left ventricular outflow by virtue of marked mitral valve systolic anterior motion. Before echocardiographic study, each of the 4 patients with HC had signs or symptoms of cardiac disease, but the correct diagnosis had not been suspected. Of 11 other patients who were referred for echocardiographic study because of a clinical suspicion of HC, none proved to have this disease. The present study demonstrates that HC is a particularly uncommon disease entity occurring in about 0.5% of an unselected outpatient population referred for echocardiographic study.

Toxic pyrolysis products of solvents, paints, and polymer films

The organic chemicals used for solvents, paint, and polymer films are resistant to heat, but if the temperature is raised sufficiently, all will pyrolyze or degrade thermally to form new, lower-molecular-weight chemical species. The solvents include nonhalogenated and halogenated varieties, and their possible occupational exposures and reaction products are described. Paint and paint-like coatings, when pyrolyzed, always produce smoke, but toxic metals included as pigment may produce hazardous fumes. The condition "meat wrapper's asthma" is described to illustrate the effects once believed due to PVC pyrolysis.

Comparison of full- and half-dose gadolinium-DTPA: MR imaging of the normal sella

PURPOSE

This study compares sellar intensities in 17 patients without sellar pathology using half (0.05 mmol/kg, nine patients) and full-dose (0.1 mmol/kg, eight patients) gadopentetate dimeglumine (Gd-DTPA).

METHODS

Sellar MR studies of eight patients who received full and nine patients who received half-dose Gd-DTPA were compared, retrospectively. Sequences included pre-, immediate, and delayed postcontrast T1-weighted coronal images (1.5 T). Intensity measurements were obtained by two observers using a uniform region of interest.

RESULTS

Comparison of normalized intensities revealed no significant difference between intensities obtained from immediate half- and full-dose techniques for any of the tissues examined (Student's t test, P < .90). Delayed scans likewise demonstrated no significant intensity differences between full- and half-dose studies.

CONCLUSION

Our findings suggest that a 50% reduction in dosage of Gd-DTPA for sellar MR at 1.5 T results in no significant diminution in intensity of enhancement of the pituitary gland or adjacent tissues.

Effect of an arginine-specific ADP-ribosyltransferase inhibitor on differentiation of embryonic chick skeletal muscle cells in culture

Primary cultures of embryonic chick skeletal myogenic cells were used as an experimental model to examine the possible role of mono(ADP-ribosyl)ation reactions in myogenic differentiation. Initial studies demonstrated arginine-specific mono(ADP-ribosyl)transferase activity in the myogenic cell cultures. We then examined the effect of a novel inhibitor of cellular arginine-specific mono(ADP-ribosyl)transferases, meta-iodobenzylguanidine (MIBG), on differentiation of cultured embryonic chick skeletal myoblasts. MIBG reversibly inhibited both proliferation and differentiation of embryonic chick myoblasts grown in culture. Micromolar (15-60 microM) concentrations of MIBG blocked myoblast fusion, the differentiation-specific increase in creatine phosphokinase activity, and both DNA and protein accumulation in myogenic cell cultures. Meta-iodobenzylamine, an analog of MIBG missing the guanidine group, had no effect. Low concentrations of methylglyoxal bis-guanylhydrazone, a substrate for cholera toxin with a higher Km than MIBG, also had no effect, but higher concentrations reversibly inhibited fusion. These findings suggest a possible role for mono(ADP-ribosyl)ation reactions in myogenesis. In addition, the total arginine-specific mono(ADP-ribosyl)transferase activity increased with differentiation in the myogenic cell cultures, and this increase was also blocked by MIBG treatment. Because high levels of activity were found in the membrane fraction derived from later, myotube cultures, the membrane fraction from 96-h cultures was incubated with [32P]NAD+ and subjected to electrophoresis and autoradiography. Three proteins, migrating at 21, 20, and 17 kDa, that were ADP-ribosylated in the absence, but not the presence, of MIBG were identified. These proteins may be endogenous substrates for this enzyme.

Health views from the Senate. Interview by Maria T. Montesano

The state legislature is comprised of a mixture of personalities and viewpoints. In this first of a series of three interviews with members of the general assembly, Senators John Peterson and J. Doyle Corman talk about life in rural Pennsylvania, what physicians can do to be more involved in the political process, and a number of other issues.

Heliotropium europaeum poisoning of sheep with low liver copper concentrations and the preventive efficacy of cobalt and antimethanogen

In a field experiment in the Mallee district of Victoria, Merlno xBorder Leicester ewes and wethers grazed Heliotropium europaeum (heliotrope) over periods of 3 to 4 months in 4 successive years. By the end of the second year 12% (14 of 120) of the sheep had died; after 4 years the loss attributable to heliotrope was between 18% and 35%. Mortality was not affected by intraruminal treatment with cobalt or antimethanogen. At the end of the experiment the highest concentration of copper in the liver was 1.95 mmol/kg wet weight (approximately 413 micrograms/g dry weight). The relatively low mortality from primary heliotrope poisoning and the low concentration of copper in the liver of sheep grazing the plant are discussed in relation to the contrasting situation that prevails in the Riverina area of New South Wales. The importance of local environmental factors in the management of heliotrope grazing by sheep is emphasised, particularly in relation to the number of seasons in which the plant may be a major component of the diet.

Limitations of ambient air quality standards in evaluating indoor environments

Analysis of the kinds of data used for the derivation of ambient air quality standards (AAQSs) for carbon monoxide and ozone shows that these values are based on the toxicology of the materials and thus are suitable for evaluating potential health effects of indoor environments, especially on the very young, the aged, and the infirm. A similar analysis shows that the AAQSs for suspended particulate matter, nitrogen dioxide, and sulfur dioxide are strictly empirical and that they should not be used for any but their first, intended purpose. The AAQSs for non-methane hydrocarbons are based on photochemical smog production, not injury of any kind, and have no utility for indoor environment evaluation.

Oral habits. A behavioral approach

Thumb-sucking, pacifier use, and other oral habits are not so harmful or beneficial to the child to justify ill-timed aggressive discontinuance. Indeed there is ample time to guide the child to forming desired behaviors. In nearly every case success in habit management depends on the child making a personal commitment to discontinue the habit. Control can be placed in the child's hands after that decision is made.

Comparison of ultrasonography and oral cholecystography in lithotripsy. II. Determining retreatment

Both ultrasonography (US) and oral cholecystography (OCG) are being used to evaluate patients after extracorporeal shock wave lithotripsy (ESWL) for gallstones. Criteria for retreatment after the initial ESWL are usually related to the size of the residual fragments. This study examines the efficacy of ultrasound and OCG for determining both the size and number of stone fragments in the gallbladder in an in vitro model and in patients. Ultrasonography and OCG examinations using an in vitro ESWL phantom with ten groups of stones, and on 39 patients, were reviewed independently by three radiologists to determine both the size and number of stone fragments. For the in vitro study, the three readers estimated the correct number of fragments, or the next closest range, in 87% of observations by OCG and in 43% by US. The size of the largest fragment was measured within 1 mm of its actual size in 87% of observations by OCG and 20% by US. Correlation coefficients for the mean measurements of the three readers versus the actual fragment size and number were greater for OCG than for US. For the in vivo study, the three readers agreed in 47% of the OCG versus 32% of US examinations with respect to the number of fragments, and in 65% of OCG compared to 40% of US studies with respect to size of the largest fragment. Multiple statistical analyses demonstrate that these differences are statistically significant. A discrepancy among the readers concerning whether a patient was eligible for retreatment occurred in 15% of OCG as compared to 45% of US studies. Both the in vivo and in vitro studies indicate that there is more interobserver reproducibility for OCG than for US, and that OCG is more reliable in making the decision concerning patient eligibility for retreatment following lithotripsy.

Comparison of ultrasonography and oral cholecystography in biliary lithotripsy. I. Screening patients

Ultrasound and oral cholecystography (OCG) are both used to evaluate candidates for biliary lithotripsy. Some investigators have suggested abandoning the OCG, believing that sufficient screening information can be obtained from ultrasound. This study compares ultrasound and OCG in assessing the size and number of gallstones, both in vitro and in vivo. In the in vitro model, 35 gallstones, divided into 20 groups, were separately suspended in dilute contrast media in a phantom, and examined by ultrasound and simulated OCG by each of three gastrointestinal radiologists. In the in vivo study, the ultrasound and OCG examinations from 53 patients were independently reviewed by three radiologists. The number and size of the stones were recorded in both studies. In the in vitro study, the stone size was measured within 2 mm of the actual size by OCG in 23/35 stones (66%) and by ultrasound in 4/35 stones (11%). The correct number of stones was determined by OCG in 19/20 groups (95%), and by ultrasound in 14/20 (70%). In the in vivo study, all readers saw the same number of stones in 40/50 (80%) patients by OCG and 33/49 (67%) patients by ultrasound. Statistical analyses revealed correlation coefficients for OCG greater than those for ultrasound in each comparison. The size of the largest stone was within 2 mm by all readers in 26/51 (51%) of patients by OCG and 20/47 (43%) patients by ultrasound. Oral cholecystography is more reliable than ultrasound for the determination of size and number of stones in patients being screened for biliary lithotripsy.

Hepatic dynamic sequential CT: section enhancement profiles with a bolus of ionic and nonionic contrast agents

The enhancement characteristics in different portions of the liver during dynamic sequential bolus computed tomography (CT) with iodinated contrast material (DSBCT) were prospectively evaluated in 75 patients by using iothalamate meglumine, iopamidol, and iohexol (25 patients received each agent). After baseline noncontrast CT was performed, DSBCT was performed with a 180-mL intravenous bolus administered at 2 mL/sec. Scanning was started 25 seconds after the bolus was initiated, by using a 3-second scan time and rapid cephalocaudal table incrementation, yielding contiguous 8-mm-thick sections at a rate of nine sections per minute. On postcontrast images, peak enhancement was 115% for iopamidol and 117% for iohexol, both of which were superior to iothalamate meglumine at 95% (P less than .05). After peaking, enhancement then decreased for all three contrast agents, although the decline was more precipitous for iothalamate meglumine. Enhancement on the more caudal sections with both iopamidol and iohexol was superior to that with iothalamate meglumine (P less than .05). The data suggest that the enhancement characteristics for the two nonionic agents may be more optimal for detection of focal hepatic lesions than the ionic agent.

Determination of the kinetic mechanism of arginine-specific ADP-ribosyltransferases using a high performance liquid chromatographic assay

A high performance liquid chromatographic method has been developed for the assay of arginine-specific ADP-ribosyl transferases. The assay utilizes L-arginine methyl ester (LAME) as the acceptor substrate. ADP-ribosylated-LAME is separated from the reaction mixture using a C-8 reversed-phase column. Before injection, the assay mixture is derivatized with an orthophthaldialdehyde/2-mercaptoethanol reagent. Fluorescence detection of the orthophthaldialdehyde-derivatized product provides excellent sensitivity and a limit of detection of less than 100 fmol. The kinetic mechanism of two arginine-specific ADP-ribosyltransferases, cholera toxin A subunit and an endogenous transferase from rabbit skeletal muscle, were both determined to be random sequential. The kinetic studies utilized 3-aminobenzamide and NG-monomethylarginine as competitive inhibitors for NAD and LAME, respectively. Cholera toxin was reported to have Km values of 5.6 and 39 mM for NAD and LAME, respectively. Km values of 0.56 and 1.2 mM were determined for NAD and LAME, respectively, using the transferase from rabbit skeletal muscle.

Purification and partial characterization of arginine-specific ADP-ribosyltransferase from skeletal muscle microsomal membranes

Integral membrane-associated arginine-specific mono-ADP-ribosyltransferase was purified from rabbit skeletal muscle microsomes. The ADP-ribosyltransferase was solubilized from the 100,000 x g pellet with 0.3% sodium deoxycholate and purified to greater than or equal to 95% homogeneity by successive DE52, concanavalin A-agarose, 3-aminobenzamide-agarose, and size-exclusion high-performance liquid chromatography (HPLC) steps in the presence of detergents. Two molecular weight forms of the enzyme were isolated and partially characterized. The apparent Mr of the alpha-form of the enzyme purified to greater than or equal to 95% homogeneity was approximately 39,000 +/- 500 as estimated by silver-stained sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The Mr of the beta-form purified to greater than or equal to 80% homogeneity was 38,500 +/- 500. The rapid procedure resulted in a 200-fold purification for the alpha-form and a 645-fold purification for the beta-form, relative to the microsomal fraction. Positive identification of the enzyme was confirmed by utilizing a zymographic in situ gel assay and by HPLC assay of polyacrylamide gel slice incubations with an NAD and guanylhydrazone substrate. The specificity of the mono-ADP-ribosyltransferase zymographic assay was characterized by time course incubations, hydroxylamine sensitivity, 3-aminobenzamide inhibition, and histone dependence. The ADP-ribosyltransferase is inactivated by reducing agents.

Biliary hyperplasia and carcinogenesis in chronic liver damage induced in rats by phomopsin

Phomopsin, a hexapeptide mycotoxin contaminant of lupin plant and seed materials, was administered subcutaneously to adult rats at a daily dose rate of 30 micrograms/kg body weight (approximately 0.005 median lethal dose) for 2, 6 or 17 wks and the development of liver damage was observed during treatment and for up to 2 yr after. All rats injected for 17 wks developed permanent liver damage characterized by nodular cirrhosis and extensive biliary hyperplasia. Cholangiomas developed in 60% of these rats and cholangiocarcinomas and hepatocellular carcinomas in 13%. Similar effects were produced in some rats injected for 6 wks, while in others the cessation of treatment was followed by almost complete regression of the liver lesions. Livers damaged by 2 wks of injection had fully recovered within a few wks. The permanence of the liver damage is relevant to the management of stock exposed seasonally to the toxin, while its carcinogenic potential in rats, although not high, indicates the need for monitoring of the phomopsin content of lupin seed or flour prepared for human consumption.

Purification and characterization of the 22-kilodalton potato tuber proteins

Three abundant proteins of approximate molecular masses of 22, 23, and 24 kilodaltons were purified from potato (Solanum tuberosum L.) tubers by DEAE cellulose and CM-52 cellulose ion exchange column chromatography, electroelution, and high-pressure liquid chromatography (HPLC). Antibodies specific to the gel-purified 22-kilodalton protein were prepared. Immunoblot analysis showed that the 22-, 23-, and 24-kilodalton proteins are immunologically related and that these proteins are present in tubers and as higher molecular mass forms in leaves, but not in stems, roots, and stolons. The ratios of amino acid composition were compared among the three purified proteins, and the aminoterminal amino acid sequences were determined for these three proteins. All three proteins have identical amino-terminal sequences that match the deduced amino acid sequence of an abundant tuber protein cDNA.

Contrast-enhanced CT of the liver and spleen: comparison of ionic and nonionic contrast agents

We conducted a randomized, blinded, prospective study evaluating hepatic parenchymal density changes during dynamic bolus CT (180 ml of contrast material given IV) and delayed CT (5 hr after 60 g of iodine) in order to compare the enhancement characteristics of an ionic contrast agent (iothalamate-60) and two nonionic agents (iohexol-300 and iopamidol-300). A total of 75 patients with known or suspected cancer were studied (25 patients per contrast agent). After a baseline unenhanced CT scan was obtained, dynamic bolus and delayed CT scans were obtained for all patients with one of the three contrast agents. The density of the liver and spleen was measured in Hounsfield units (H) for unenhanced CT, dynamic bolus CT, and delayed CT. The average percentage of enhancement was calculated as follows: postcontrast density minus precontrast density was divided by precontrast density and then multiplied by 100. For dynamic bolus CT, the average percentage of enhancement of the liver was 105% when iohexol-300 was used, 98% when iopamidol-300 was used, and 83% when iothalamate-60 was used. No significant difference was seen between the postcontrast enhancement of the three contrast agents on dynamic bolus CT scans (p greater than .05). For delayed CT, the average percentage of enhancement of the liver was 34% when iothalamate-60 was used, 28% when iopamidol-300 was used, and 16% when iohexol-300 was used. Both iothalamate-60 and iopamidol-300 showed superior enhancement on delayed CT, compared with iohexol-300 (p = .0001). We conclude that for dynamic bolus CT, all three contrast agents are similar, with no statistically significant differences in postcontrast enhancement of the liver. For delayed CT, however, hepatic enhancement with iothalamate-60 and iopamidol-300 is statistically superior to that with iohexol-300.

Renal corticomedullary junction. Performance of T1-weighted MR pulse sequences

Inability to demonstrate the renal corticomedullary junction (CMJ) on magnetic resonance (MR) images has been reported in connection with several medical renal diseases. T1-weighted spin echo pulse sequences have been advocated to demonstrate a signal intensity difference between cortex and medulla. This study was undertaken to determine which of several T1-weighted spin echo (SE) and gradient echo (GE) sequences are better for delineation of the CMJ. The MR studies were performed at 0.5 Tesla on 27 normal volunteers. Multi-slice axial images of both kidneys were obtained in all subjects at each of the following five pulse sequences: SE 250/20, SE 500/30, SE 900/30, and GE 300/15 with 80 degrees and 64 degrees flip angles. Contrast/noise ratios were calculated for the signal intensity differences between cortex and medulla; the average standardized contrast/noise ratios ranked as follows: GE 300/15/80 degrees = 3.01 +/- 0.74, GE 300/15/64 degrees = 2.72 +/- 0.74, SE 250/20 = 2.02 +/- 0.33, SE 500/30 = 1.96 +/- 0.51, and SE 900/30 = 1.71 +/- 0.39. In addition, the five sequences for each patient were randomized and the images were independently ranked for delineation of CMJ by three MR radiologists. The cumulative subjective ranking for all observers from best to worst is as follows: SE 500/30, GE 300/15/80 degrees, GE 300/15/64 degrees, SE 900/30, SE 250/20. Although better contrast/noise ratios are achieved with the GE sequences and the more T1-weighted SE sequences, as a practical matter this does not seem to be the only significant factor when compared with the visual image evaluation by independent observers.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapies to limit infarct size. Timing, dosage, and effectiveness

Rapid diagnosis of an evolving acute myocardial infarction and institution of thrombolytic therapy in appropriate patients can markedly decrease infarct size and thus reduce cardiovascular morbidity and mortality. Streptokinase (Kabikinase, Streptase) and recombinant tissue plasminogen activator (Activase) are both widely used, effective clot-dissolving agents. Patients who are not candidates for thrombolytic therapy can be treated with other methods, such as anticoagulant therapy, which can greatly reduce infarct size. Intravenous heparin, beta blockers, nitroglycerin, and aspirin have all been shown to limit infarct size, decrease mortality, or do both in patients with acute myocardial infarction.

Expression and characterization of the tau subunit of phosphorylase kinase

A cDNA encoding the entire tau subunit of rabbit skeletal muscle phosphorylase kinase was reconstructed and inserted into a plasmid containing the Escherichia coli ptac promoter and a constructed plasmid containing the ptac promoter and bacterial chloramphenicol acetyl transferase (CAT) gene, respectively. A significant phosphorylase kinase activity was found, in the first case. In the second case, a fused protein containing 73 amino acids from the CAT protein was obtained. After renaturation, the CAT-tau subunit protein shows enzymatic activity similar to the HPLC-purified and renatured tau subunit.

Expression of multiple types of N-methyl Phe pili in Pseudomonas aeruginosa

The nature of pili synthesized by Pseudomonas aeruginosa when plasmid-borne genes of homologous pilins from Bacteroides nodosus are introduced as thermoregulated expression systems has been ascertained. Expression of B. nodosus pili inhibited the production of indigenous P. aeruginosa pili, and an organism harbouring pilin genes from two strains of B. nodosus produced two serologically distinct populations of pili on each cell. Simultaneous production of both indigenous and foreign pili was achieved by partial induction of expression. Homogeneity in pilus structure suggests either that there is an exclusive specificity of interaction between identical pilin subunits in pilus assembly, or that each pilus is produced from the translation products of a single messenger RNA molecule, with translation and pilus assembly closely coupled.

The toxicity of phomopsin for sheep

Pure phomopsin was administered to young Merino x Border Leicester wethers by single subcutaneous (SC) and by single and multiple intraruminal (IR) injection. The toxicity after IR injection was influenced by the size of individual doses and the time over which the total dose was given. At high levels of ingestion the toxicity of phomopsin may be limited by absorption rates; with low daily doses the capacity to repair liver damage may be sufficient to prevent cumulative effects. By SC injection a single dose of 10 micrograms/kg approximated the LD50. By IR injection the overall clinical, biochemical and histological responses closest to these of this SC dose resulted from a single dose of 1,000 micrograms/kg. The same total dose administered at daily rates of 50 or 200 micrograms/kg was more toxic and killed all sheep. A single dose of 500 micrograms/kg caused significant liver damage, but no deaths. Single doses of 125 and 250 micrograms/kg and repeated daily doses of 12.5 micrograms/kg over 16 weeks caused no detectable tissue damage. Inappetence was the most sensitive indicator of phomopsin toxicity. About 10% of the sheep differed substantially from the rest of the flock in their susceptibility to phomopsin poisoning.

Developmental enamel defects of the primary dentition in a group of Californian children

The parent of each three- to six-year old child with enamel defects, seen at the Loma Linda University School of Dentistry between 1981 and 1982, was interviewed to find an explanation for the defect. The most frequently given was hyperbilirubinemia.

Expression of pili from Bacteroides nodosus in Pseudomonas aeruginosa

The pili of Bacteroides nodosus, the causative agent of ovine footrot, constitute the major host-protective immunogen against homologous serotypic challenge. The pilin gene from B. nodosus 198 has been cloned and morphologically expressed as extracellular pili in Pseudomonas aeruginosa by using a plasmid-borne, thermoregulated expression system. B. nodosus pilin could not be detected in cultures of P. aeruginosa grown at 32 degrees C, but after induction at 37 degrees C, B. nodosus pili were expressed on the cell surface of P. aeruginosa to the virtual exclusion of the host cell pili. Pili harvested from induced P. aeruginosa cultures were used to immunize sheep against footrot. The serum agglutinating antibody titers of vaccinated sheep were comparable to those of sheep receiving pili from B. nodosus. Subsequent challenge of the sheep with B. nodosus 198 indicated that the recombinant- DNA-derived pili vaccine and the B. nodosus pili vaccine provided similar levels of protection against footrot.

The pathogenicity and cultural characteristics of virulent, intermediate and benign strains of Bacteroides nodosus causing ovine foot-rot

The relationship between the cultural and biochemical characteristics of 22 strains of Bacteroides nodosus and their virulence for sheep was examined. Virulent, intermediate and benign strains were recognised. Although there was some relationship between virulence and colony morphology on hoof medium with 4% agar, colonies of one virulent and 4 intermediate strains resembled those of benign strains. However, on hoof medium with 2% agar and on blood Euonagar, colonies of this virulent and one intermediate strain differed from each other and the other 3 intermediate strains, which in turn differed from the benign. The degree of piliation, as assessed by electron microscopy, was not a reliable indicator of virulence in strains not possessing a beaded colony type. Together, the results of colony morphology and proteolytic tests such as zymogram, degrading proteinase and elastin-agar tests allowed better discrimination of virulent and benign strains. Intermediate strains generally possessed virulent protease activity. In strains with benign zymogram patterns, activity bands 2 and 3 were more labile than in strains with virulent patterns. The addition of CaCl2 to the culture medium resulted in greater stability of proteolytic activity, particularly with benign strains, and prevented the disappearance of protease activity in the band 5 position in virulent, intermediate and benign strains during prolonged incubation. There were slight differences in the sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) patterns of outer membrane proteins of some benign strains but those of intermediate category resembled virulent strains. There was some relationship between the apparent Mr of the pilin monomer on SDS-PAGE gels and serogroup specificity.

Cross-protection from Bacteroides nodosus vaccines and the interaction of pili and adjuvants

The effects of vaccination of Merino sheep with the purified pili or the whole cells of Bacteroides nodosus strain 198, either in oil or alum-oil adjuvant, on the severity of foot-rot induced with the homologous strain (198) and a heterologous strain (217) were determined in a field experiment, on flood irrigated pasture. The efficacy of the whole cell vaccines was comparable to that of purified pili vaccines, against homologous challenge, when both had a similar content of pilus antigen although the purified pili vaccines induced significantly greater homologous pilus agglutinating antibody titres than the whole cell vaccines. However, against heterologous challenge, the whole cell vaccines in oil (CO) or alum-oil (CAO) provided significantly greater protection than a purified pili-in-oil (PPO) vaccine, the number of severely affected feet in sheep vaccinated with PPO being similar to that of the unvaccinated group. The group vaccinated with purified pili in alum-oil (PPAO) was intermediate between these two extremes. The superior performance of the PPAO in comparison to the PPO vaccine, against heterologous challenge, was associated with significantly higher mean ELISA titres to the outer membrane complex. Western blot analyses implicated a role in cross-protection for outer membrane proteins, in particular a protein Mr 78,000. The PPO vaccine produced fewer, smaller and less persistent vaccination reactions at the inoculation sites than did the other vaccines. Bodyweight gains in the period prior to challenge were much lower for the groups vaccinated with CO and CAO than for the controls and those vaccinated with purified pili, due presumably to the larger vaccination reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Early-phase endotoxin tolerance: induction by a detoxified lipid A derivative, monophosphoryl lipid A

After a sublethal exposure to lipopolysaccharide (LPS) or to lipid A, which is that portion of the LPS molecule associated with endotoxicity, a transient period ensues during which a normally responsive individual is rendered hyporesponsive to LPS-induced toxicity. This period has been defined as early-phase endotoxin tolerance. Recently, a nontoxic derivative of lipid A from Salmonella typhimurium, monophosphoryl lipid A (MPL), was isolated and purified. In this study, we assessed the ability of MPL to induce early endotoxin tolerance. Initial injection of MPL resulted in a dose-dependent stimulation of both serum colony-stimulating factor and serum interferon, indicators of in vivo LPS responsiveness. In contrast, MPL failed to induce the symptoms of endotoxicity which are normally seen after injection of even sublethal amounts of intact endotoxin or lipid A preparations. Injection of MPL on day 0 reduced significantly the amount of LPS-induced serum colony-stimulating factor and interferon produced upon challenge with Escherichia coli LPS 3 days later and also mitigated toxic manifestations, as evidenced by a marked increase in the 50% lethal dose. Like the early tolerance induced by wild-type (toxic) LPS, MPL-induced tolerance was characterized by an accompanying elevation in the number of bone marrow-derived macrophage progenitor cells and by an alteration in bone marrow cell sizing profiles. These results indicate that MPL is effective in inducing a state of LPS-hyporesponsiveness without the toxic side effects of endotoxin and that the structural component(s) necessary for induction of early-phase endotoxin tolerance is contained within MPL.

Massive bleeding due to arterial-enteric fistula from an ingested toothpick

A 62-year-old man developed massive lower gastrointestinal tract bleeding. Upper endoscopy and superior mesenteric arteriography initially failed to disclose a cause of bleeding. On rebleeding, intra-arterial vasopressin infusion during repeated arteriography caused reflux of dye into the iliac vessels to allow visualization of an arterial-enteric fistula. Exploratory laparotomy subsequently revealed perforation of the small bowel and common iliac artery by a toothpick which had been swallowed.