Effects of temperature and salinity on blood chemistry and survival of juvenile Atlantic tarpon Megalops atlanticus

Atlantic tarpon Megalops atlanticus are highly migratory sportfish that support recreational fisheries throughout their range. In U.S. waters, juveniles can be found in coastal and estuarine habitats along the Gulf of Mexico and Atlantic seaboard, with temperature limiting their northern latitudinal distribution. Juveniles may overwinter in these areas during the first several years of life. Low temperatures are known to cause mortality in adults, but the challenges of temperature are less understood for juveniles. Furthermore, salinity, which can change dramatically in these habitats, may have a synergistic effect with temperature. To examine the physiological effects of temperature and salinity on juvenile tarpon, wild fish were acclimated to a range of conditions that potentially occur in the northern range of their estuarine habitats. The haematology of juvenile tarpon was examined in two salinity (≤2 and ≥30 ppt) and temperature (15 and 25°C) treatments, followed by a low temperature tolerance test. After two weeks in treatment conditions, blood samples were analyzed for hematocrit, pH, red blood cell concentration, haemoglobin content, and plasma osmolality. Increased plasma osmolality was observed in fish at low temperature (15°C compared to 25°C) and at high salinity (≥30 ppt compared to ≤2 ppt). Blood pH was increased at 15°C compared to 25°C, with the highest pH at 15°C and low salinity. Haemoglobin, hematocrit and red blood cell concentration were higher at 25°C than 15°C, with haemoglobin lowest at 15°C and low salinity. For the low temperature tolerance test, all fish were acclimated to 15°C for 2 weeks, then transferred to separate tanks where temperature was gradually decreased at 0.9 ± 0.1°C/hr until fish lost equilibrium. Fish at low salinity lost equilibrium more rapidly (1 ppt, 12.65 ± 0.46°C) than fish at high salinity (30 ppt, 11.26 ± 0.14°C). Results indicate juvenile tarpon are susceptible to low temperature, which is exacerbated by low salinity, findings useful in assessment of juvenile tarpon overwintering habitat.

Successful management of an unstable paediatric laryngeal injury in a low-resource setting

Laryngeal injury is rare but has a very high mortality rate. Compared to adults, laryngeal injury in children is more uncommon due to both behavioural and anatomical reasons. Severe laryngeal injury may require surgical repair, intensive care support and tracheostomy care, all of which are difficult to achieve in a low resource setting. We report a case of successful management of laryngeal trauma in a child involving an emergency tracheostomy insertion, open repair of thyroid cartilage fracture, tracheal stenting and successful decannulation after 8 weeks post-injury with full recovery.

Does the application of Opsite⋄ Flexigrid⋄ occlude the oxygen saturation readings in healthy individuals using the moorVMS-OXY machine?

Background

A proportion of people who have been diagnosed with peripheral arterial disease and diabetes mellitus will be susceptible to chronic wounds. Oxygen is vital for wound healing, so oxygen measurements should to be taken as predictive values for wound healing in patients. When measuring oxygen at the wound bed, there is potentially a risk of cross-infection if no protective barrier is used; and skin stripping if an adhesive barrier is used on the wound bed. This cross sectional within subject repeated measures pilot study, aims to determine if the application of opsite film, as an infection control measure, in one or two layers, impacts on tissue oxygenation readings obtained when using the MoorVMS-OXY.

Methods

Mean oxygen saturation percentages were measured from 29 limbs of 18 healthy participants. Oxygen saturation was measured for 20 s and analysed at the first metatarsophalangeal joint using no film, one and two layers using the MoorVMS-OXY. A one-way repeated ANOVA with a Bonferroni post hoc test was performed to test for statistically significant differences between the values of the three parameters and multiple pairwise comparisons was completed.

Results

Amongst the three layers, there was a statistically significant difference in oxygen saturation between the two layers of Opsite Flexigrid and none; and also between the two layers of Flexigrid and single layer (p < 0.05). It was also established that there was no statistically significant difference between the single layer of Opsite Flexigrid and no Flexigrid layer (p > 0.05).

Conclusions

The results imply that one layer of Opsite Flexigrid is a suitable protective barrier to use when establishing capillary bed oxygen perfusion with the MoorVMS-OXY. However, the application of two Opsite Flexigrid layers, to prevent skin stripping, decreases the recorded values of oxygen saturation percentages significantly, therefore providing inaccurate results. Indicating that a double layer cannot be used over ulceration sites if measuring oxygen levels at the wound bed.

Mobility in Community Dwelling Older Adults: Predicting Successful Mobility Using an Instrumented Battery of Novel Measures

Mobility in older adults is associated with better quality of life. However, evidence suggests that older people spend less time out-of-home than younger adults. Traditional methods for assessing mobility have serious limitations. Wearable technologies provide the possibility of objectively assessing mobility over extended periods enabling better estimates of levels of mobility to be made and possible predictors to be explored. Eighty-six community dwelling older adults (mean age 79.8 years) had their mobility assessed for one week using GPS, accelerometry and self-report. Outcomes were: number of steps, time spent in dynamic outdoor activity, total distance travelled and total number of journeys made over the week. Assessments were also made of personal, cognitive, psychological, physical and social variables. Four regression models were calculated (one for each outcome). The models predicted 32 to 43% of the variance in levels of mobility. The ability to balance on one leg significantly predicted all four outcomes. In addition, cognitive ability predicted number of journeys made per week and time spent engaged in dynamic outdoor activity, and age significantly predicted total distance travelled. Overall estimates of mobility indicated step counts that were similar to those shown by previous research but distances travelled, measured by GPS, were lower. These findings suggest that mobility in this sample of older adults is predicted by the ability to balance on one leg. Possible interventions to improve out-of-home mobility could target balance. The fact that participants travelled shorter distances than those reported in previous studies is interesting since this high-functioning subgroup would be expected to demonstrate the highest levels.

The rapid and accurate categorisation of critically ill patients (RACE) to identify outcomes of interest for longitudinal studies: a feasibility study

The capacity to measure the impact of an intervention on long-term functional outcomes might be improved if research methodology reflected our clinical approach, which is to individualise goals of care to what is achievable for each patient. The objective of this multicentre inception cohort study was to evaluate the feasibility of rapidly and accurately categorising patients, who were eligible for simulated enrolment into a clinical trial, into unique categories based on premorbid function. Once a patient met eligibility criteria a rapid 'baseline assessment' was conducted to categorise patients into one of eight specified groups. A subsequent 'gold standard' assessment was made by an independent blinded assessor once patients had recovered sufficiently to allow such an assessment to occur. Accuracy was predefined as agreement in >80% of assessments. One hundred and twenty-two patients received a baseline assessment and 104 (85%) were categorised to a unique category. One hundred and six patients survived to have a gold standard assessment performed, with 100 (94%) assigned to a unique category. Ninety-two patients had both a baseline and gold standard assessment, and these agreed in 65 (71%) patients. It was not feasible to rapidly and accurately categorise patients according to premorbid function.

Diagnostic value and implications of vimentin expression in normal, reactive and neoplastic endocervical epithelium

AIMS

To assess vimentin immunoreactivity in normal, reactive and neoplastic endocervical epithelium, and compare the results with p16 protein, Ki-67 and bcl-2 expression.

METHODS

Sixty-two cervical biopsy specimens including normal endocervical epithelium, tubo-endometrioid metaplasia, adenocarcinoma in situ, stratified mucin producing intraepithelial lesions (SMILE), and invasive adenocarcinomas were stained immunohistochemically for vimentin and for p16 protein, Ki-67 and bcl-2. Twelve cases also included areas of high grade cervical intraepithelial neoplasia (CIN).

RESULTS

Normal endocervical epithelium usually showed subtle but distinct sub-nuclear and delicate lateral cell border vimentin expression while tubo-endometrioid metaplasia exhibited more diffuse cytoplasmic immunoreactivity. Usually adenocarcinoma in situ was completely negative and therefore vimentin staining sharply distinguished the benign and neoplastic epithelial elements. The SMILE lesions and high grade CIN were also vimentin negative in most cases. Most invasive adenocarcinomas were not stained but focal vimentin immunoreactivity was observed in 7/18 cases, and was restricted to small glands and infiltrating cell clusters at the deep (advancing) tumour margin.

CONCLUSIONS

Normal endocervical cells often exhibit vimentin staining, and this is increased in reactive and metaplastic situations, whereas adenocarcinoma in situ is usually completely negative. Therefore vimentin is a useful additional diagnostic marker in the assessment of problematic cervical glandular lesions. The localised re-expression of vimentin at the deep margin of some endocervical adenocarcinomas may be relevant to the process of tumour progression and invasion in these cases.

Description of clinical and pathological findings, treatment and outcome of feline large granular lymphocyte lymphoma (1996-2004)

Feline large granular lymphocyte (LGL) lymphoma is an uncommon, morphologically distinct variant of feline lymphoma. Limited information exists in the literature regarding pathological and immunohistochemical descriptions, clinical findings, treatment and survival times. The purpose of this study was to describe clinical features, treatment and outcome in feline LGL lymphoma. Medical records of 45 cats with LGL lymphoma were retrospectively evaluated. Decreased appetite/anorexia, weight loss, lethargy and vomiting were the most commonly reported clinical signs. All cats tested for feline leukaemia virus and feline immunodeficiency virus infection were negative. The mesenteric lymph nodes and small intestine were the most commonly affected organs. One complete response and six partial responses were noted in the 23 cats that received chemotherapy as their initial treatment. Median survival time for cats that were treated was 57 days. Based on these results, feline LGL lymphoma appears to be minimally responsive to chemotherapy and is associated with a grave prognosis.

Nasal and nasopharyngeal lymphoma in cats: 50 cases (1989-2005)

Lymphoma is the most common nasal cavity tumor in cats, yet few reports specifically address the anatomic, immunohistologic, and cytologic features of this neoplasm. Fifty cats were diagnosed with lymphoma at necropsy, via biopsy or by cytology alone. Ten cats displayed multiorgan involvement, and in 2 of these the involvement was limited to the cerebellum and frontal cortex, respectively. Of the tumors, 41 of 50 (82%) were classified as nasal lymphoma, 5 of 50 (10%) were classified as nasopharyngeal lymphoma, and 4 of 50 (8%) involved both nasal and nasopharyngeal tissue. Histologically, all were considered diffuse lymphoid neoplasms and no cats displayed features of follicular lymphoma. Of the 44 cases available for slide review by the pathologist, 40 of 44 (91%) were classified as immunoblastic lymphoma, 2 of 44 (5%) as diffuse large cell, and 1 as diffuse mixed; 1 was unclassified. Of the 45 cats for which immunohistochemical stains were available, 32 were uniformly positive for CD79a, 7 were uniformly CD3 positive, and 6 had a mixed population of CD79a and CD3 cells. Epithelioptropism was exhibited in 4 of 5 (80%) cats in which there was sufficient epithelium present for evaluation. Of those 4, 3 were B-cell and 1 was a granulated T-cell lymphoma. In the 21 cats which nasal cytology was performed, 15 were cytologically diagnosed with lymphoma; the diagnoses in the remaining five cats were inflammatory (n = 4), normal lymphoid tissue (n = 1), or nondiagnostic (n = 1). The most common biochemical abnormalities were panhyperproteinemia in 26/46 (57%) of cats and hypocholesterolemia in 11/46 (24%) of cats.

Successful establishment of long-term bone marrow cultures in 103 patients with myelodysplastic syndromes

We used bone marrow biopsies instead of mononuclear cells to maintain long-term cultures from 103 patients belonging to all five sub-categories of myelodysplastic syndromes (MDS), as well as 12 normal controls. By week 4, 30-50% confluency was reached and could be maintained for up to 12 weeks with 100% confluency. The four prominent cells were fibroblasts, macrophages, endothelial cells and adipocytes. Immunohistochemical and electron microscopic studies provided lineage confirmation. Normal hematopoiesis was well supported by MDS stroma. Neither the FAB nor cytogenetics was co-related with the potency of growth. MDS stroma appears to be both morphologically and functionally normal.

Memory of childhood sexual abuse among clinicians: characteristics, outcomes, and current therapy attitudes

This paper reports preliminary data on a sample of therapists with memory of childhood sexual abuse. Therapists who reported experiencing childhood sexual abuse (CSA, n = 131) were compared with therapists who suspected sexual abuse but had no memories (n = 24) on variables related to abuse characteristics, outcomes, and perceived difficulties working with clients with a CSA history. Therapists who suspected abuse, in contrast to those who made definite reports, were more likely to report that the perpetrator was a family member, that their CSA did not involve physical contact, that there was alcoholism in their families of origin, and that the CSA had negative effects on their relationships with their own children, ability to trust others, sexual satisfaction, and work life. Therapists who suspected abuse also reported more difficulty treating CSA clients because of interpersonal pulls during sessions, arousal without memories of abuse, and some countertransferential behaviors. These findings indicate that issues related to personal trauma should be addressed during training and practice.

Inhibition of mast cell tryptase by inhaled APC 366 attenuates allergen-induced late-phase airway obstruction in asthma

BACKGROUND

APC 366, a selective inhibitor of mast cell tryptase, has been shown to inhibit antigen-induced early asthmatic response (EAR), late asthmatic response (LAR), and bronchial hyperresponsiveness (BHR) in a sheep model of allergic asthma.

OBJECTIVE

The purpose of this study was to investigate the effects of APC 366 on antigen-induced EAR, LAR, and BHR in mild atopic asthmatics not on any anti-inflammatory therapy.

METHODS

Sixteen mild atopic asthmatics, each with a demonstrable antigen-induced EAR, LAR, and BHR to histamine, were recruited into this randomized, double-blinded, crossover study. APC 366 (5 mg)/placebo was administered by aerosol inhalation 3 times per day on treatment days 1 through 4. Allergen challenge was carried out on day 4. Histamine challenge was performed the following morning, 1 hour after final dosing.

RESULTS

Subjects were shown to have a significantly smaller overall mean area under the curve for the LAR (P =.012) and mean maximum fall in FEV(1) for the LAR (P =.007) after pretreatment with APC 366 in comparison with placebo. No significant effects on BHR were demonstrable. Although the EAR was reduced by 18% after treatment with APC 366 in comparison with placebo, this was not statistically significant.

CONCLUSION

Short-term repeated administration of APC 366 significantly reduced the magnitude of antigen-induced LAR in atopic asthmatics, which supports the role of mast cell tryptase in the pathophysiology of the LAR.

Critical issues in the care of pregnant women with eating disorders and the impact on their children

Pregnancy and eating disorders is a subject that has received relatively little attention in the literature. Nevertheless, serious complications have been found in both the mother and the baby during both pregnancy and post partum period. This article alerts practitioners to the physical and psychological risks that imperil pregnant women with histories of recent eating disorders, describes the experiences of three women with eating disorders during pregnancy whose children developed eating difficulties, and suggests some guidelines for the screening and care of women with eating disorders and their babies.

Risk factors for assaults on nursing staff: childhood abuse and education level

OBJECTIVES

This study examined risk factors for nursing staff associated with being assaulted in the workplace and described the prevalence of staff assaults on patients.

BACKGROUND

Most studies examining assaults in the workplace examine patient variables. Scant empirical investigation has occurred of staff variables.

METHODS

A random mailed survey measuring physical and psychological assaults, sexual assault, and trauma history was employed. Childhood abuse and education were unique predictors of physical and sexual assault by patients. The results also revealed that staff members sometimes abuse patients.

IMPLICATIONS

These results can help inform the training and supervision of nursing staff. Strategies to decrease staff vulnerability of being assaulted may reduce the risk. The finding that education also may be a protective factor has important implications for trends in managed care to downsize nursing. Protecting patients and staff are important administrative priorities in the workplace.

The misunderstood child: the child with a nonverbal learning disorder

ISSUES AND PURPOSE

To introduce nurses to the characteristics of nonverbal learning disorders (NLD) and their psychosocial trajectory in children. Despite the prevalence of learning disorders in children, few nursing professionals are familiar with NLD and their manifestations.

CONCLUSIONS

The child with NLD faces unique challenges in the social, academic, visual-spatial, motoric, and emotional spheres.

PRACTICE IMPLICATIONS

Nurses can play a vital role in the identification, education, and provision of resources for these children.

Severe childhood sexual abuse and nonverbal learning disability

This article offers a review of, and case report on, the treatment of a young adult with a history of severe childhood abuse, dissociative symptoms, and right-hemisphere dysfunction, or nonverbal learning disabilities (NLD). The core of nonverbal learning disabilities is the inability to synthesize information and create meaning from complex information. Learning is a form of adaptation and disruptions in an individual's meaning-making process. There are major implications for the person's overall adjustment. Trauma is itself complex and often damaging to the survivor's well being. Clinical assessment must take into account a person's cognitive style and possible learning deficits in order to adequately address traumatic material. Therapy must be modified in order to respond to the unique learning style of the NLD client. Finally, and important issue for therapists remains their willingness to broaden their awareness and knowledge base, and shift the treatment paradigm to meet the needs of the client with neurocognitive vulnerabilities. Treating clients with difficult trauma histories' alone, can elicit negative reactions in the therapist. Repeated experiences with a client's mistrust, anger, noncompliance or self-defeating habits are particularly stressful. The neuropsychological perspective can provide a valuable tool in the mastery of those reactions, and in building a context for empathy and a joint narrative.

Manual lymph drainage (MLD)

Treatment review is intended to inform and update nurses about treatments relevant to HIV/AIDS. Information presented in this column does not imply endorsement by ANAC. Additionally, the reader is advised that there is a paucity of scientific data to validate the effectiveness of manual lymph drainage.

Teenage health education: a public health approach

This article describes a public health nursing initiative to deal with teenage health issues. The Teenage Health Club project in Alexandria, near Glasgow, provides a health education service for local teenagers. The approach allowed health professionals to develop a strategic response to the increasing problems of this client group.

Effects at two years of a low-fat, high-carbohydrate diet on radiologic features of the breast: results from a randomized trial. Canadian Diet and Breast Cancer Prevention Study Group

BACKGROUND

The appearance of breast tissue on mammography varies according to its composition. Fat is radiolucent and appears dark on mammography, while stromal and epithelial tissue has greater optical density and appears light. Extensive areas of radiologically dense breast tissue seen on mammography are associated with an increased risk of breast cancer.

PURPOSE

The purpose of the present study was to determine whether the adoption of a low-fat, high-carbohydrate diet for 2 years would reduce breast density.

METHODS

Women with radiologic densities in more than 50% of the breast area on mammography were recruited and randomly allocated to an intervention group taught to reduce intake of dietary fat (mean, 21% of calories) and increase complex carbohydrate (mean, 61% of calories) or to a control group (mean, 32% of calories from fat and 50% of calories from carbohydrates). Mammographic images from 817 subjects were taken at baseline and compared with those taken 2 years after random allocation by use of a quantitative image analysis system, without knowledge of the dietary group of the subjects or of the sequence in which pairs of images had been taken. The effects of the intervention on the mammographic features of breast area, area of dense tissues in the breast, and the percent of the breast occupied by dense tissue were examined using t tests. Multiple regression was used to examine these effects while accounting for age at trial entry, weight change, and menopausal status.

RESULTS

After 2 years, the total area of the breast was reduced by an average of 233.7 mm2 (2.4%) (95% confidence interval [CI] = 106.9-360.6) in the intervention group compared with an average increase of 26.3 mm2 (0.3%) (95% CI = -108.0-160.5) in the control group (P = .01). The area of density was reduced by 374.4 mm2 (6.1%) (95% CI = 235.1-513.8) in the intervention group compared with an average of 127.7 mm2 (2.1%) (95% CI = 8.6-246.7) in the control group (P = .01). Weight loss was associated with a reduction in breast area. The effect of the intervention on breast area was only marginally statistically significant after weight change, menopausal status, and age at trial entry were taken into account (P = .06). Greater weight loss and becoming postmenopausal were associated with statistically significant reductions in the area of density on the mammographic image at 2 years (P = .04 and P<.001, respectively). Age at entry into the trial was marginally significant in the same direction (P = .06). The effect of the intervention on area of density remained statistically significant after controlling for weight loss, age at entry, and menopausal status (P = .03). The change in the percentage of dense tissue in the mammographic image was not significantly different between the two groups (P = .71).

CONCLUSIONS AND IMPLICATIONS

These results show that after 2 years, a low-fat, high-carbohydrate diet reduced the area of mammographic density, a radiographic feature of the breast that is a risk factor for breast cancer. Longer observation of a larger number of subjects will be required to determine whether these effects are associated with changes in risk of breast cancer.

Symmetry of projection in the quantitative analysis of mammographic images

Mammographic parenchymal patterns are among the strongest indicators of the risk of developing breast cancer. Risk evaluation through breast patterns may have an important role in studies of the aetiology of breast cancer and for monitoring changes in the breast in evaluating potential risk-modifying interventions. Typically, patterns are assessed by an experienced radiologist according to Wolfe grade, or on a coarse quantitative scale according to percent density. Parenchymal characterization methods, to overcome variability of classification by human observer, are under investigation. These include image segmentation using semi-automatic thresholding and automatic classification through textural and density measures. An important practical question relates to the extent to which information about mammographic pattern is carried by any one of the four views obtained in a typical examination. Specifically, variations of right-left breast symmetry and variations between the two standard views of each breast were tested. The mammograms of 30 premenopausal women, comprising 90 images [30 each of the right cranial-caudal (RCC), left cranial-caudal (LCC) and right medial-lateral oblique (RMLO)] were evaluated. Parameters included both subjective (radiologist classification and interactive image thresholding) and objective (fractal and skewness indices) quantitative measurements of parenchymal pattern. For the parameters tested, a high degree of correlations was observed for measurements on the RCC, LCC and RMLO views. Pearson correlation coefficients between 0.86-0.96 were found for the comparisons of quantitative parameters. The strong correlations suggest that, in the study and application of mammographic density classification, representative information is provided in a single view.

Mammographic signs of potential relevance to breast cancer risk: the agreement of radiologists' classification

We have assessed the agreement of radiologists who quantitatively estimated the extent of various mammographic features of the breast. These features are of potential relevance to the estimation of the future risk of developing breast cancer. After preparation, in which various mammographic appearances and their classification were discussed and agreed upon, two radiologists, experienced in mammography, independently estimated the extent of various types of radiological density in 120 sets of mammograms, each comprised of two mediolateral and two craniocaudal views. The results showed a high level of agreement between the two radiologists in the classification of total mammographic densities (r = 0.89). For classification of specific types of density, agreement was best for homogeneous densities (r = 0.79), more intermediate for nodular densities (r = 0.71) and worst for linear densities (r = 0.48). These results show that radiologists can, with suitable preparation, identify total breast density, a mammographic sign relevant to a woman's risk of later developing breast cancer, with a high degree of agreement.

Plasma lipids, lipoproteins, and mammographic densities

There is strong evidence that the risk of breast cancer in populations is influenced by environmental factors. Plasma lipids and lipoproteins are known to be under environmental control and to have epidemiological and/or biological characteristics that suggest they may be relevant to breast cancer risk. The purpose of the study described here was to determine whether plasma lipids, lipoproteins, and the urinary excretion of the mutagen malondialdehyde (MDA) are associated with differences in breast cancer risk. We measured plasma lipids, lipoproteins, and urinary MDA in women without breast cancer but with different degrees of density of the breast parenchyma on mammography, a strong risk factor for breast cancer. Mammograms from 273 premenopausal women were digitized to high spatial resolution by a scanning densitometer, and images were analyzed to quantify the extent of density. The percentage of the breast occupied by mammographic densities was found, after controlling for the effects of age and the Quetelet index of obesity, to be significantly associated with plasma levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, apoprotein B, and urinary excretion of MDA. A multivariate model comprised of the Quetelet index of obesity, alcohol consumption, apoprotein B, parity, daily MDA excretion, and the skinfold thickness sum accounted for 36% of the variation in breast density. These results suggest that differences in lipid metabolism are associated with differences in breast cancer risk as defined by mammographic densities. These findings are consistent with several other observations that show a relationship between plasma lipids, lipoproteins, and risk factors for breast cancer.

Plasma lipids and cholesterol esterification in Alzheimer's disease

Eight patients and eight age matched controls were recruited to study parameters related to plasma lipoprotein metabolism in Alzheimer's disease based on previous studies in Down's syndrome (A.G. Lacko et al., Clin. Chim. Acta, 132 (1983) 133). The fractional rate of cholesterol esterification (% cholesterol esterified per hour) was 16% lower in the patient group compared with controls. Correlational analyses of lecithin/cholesterol acyltransferase (LCAT) activity and plasma lipids revealed additional differences between the Alzheimer's patients and control subjects. These data are strikingly similar to those obtained earlier with Down's syndrome patients. These data, combined with analyses of cholesteryl ester transfer protein (CETP) levels, suggest that reverse cholesterol transport in general and CETP activity in particular may be altered in Alzheimer's disease.

Diffusing capacity predicts morbidity and mortality after pulmonary resection

Patients who are considered for major pulmonary resection are normally evaluated by spirometry and clinical assessment. Despite this, the morbidity and mortality rates are high after these operations. We retrospectively reviewed results of lung resection performed during a period of 7.5 years in 237 patients to identify other important predictors of morbidity and mortality. There were 144 male and 93 female patients with a mean age of 59.4 +/- 11.4 years. The indication for operation was lung cancer in 199 (76 stage I, 34 stage II, 89 stage IIIA-B), benign disease in 34, and metastatic disease from other primary tumors in four. Lobectomy or bilobectomy was performed in 164 patients and pneumonectomy in 73. Data on 38 preoperative and operative risk factors were correlated with information on 24 postoperative events grouped into four major categories: death, pulmonary complications, cardiovascular complications, and other problems. Logistic regression analysis and chi 2 analysis were used to identify the relationship of the preoperative risk factors to the grouped postoperative complications. The diffusing capacity of the lung for carbon monoxide was the most important predictor of mortality (p less 0.01) and was the sole predictor of postoperative pulmonary complications (p less than 0.005). This diffusing capacity can reveal the existence of emphysematous changes in the lung, even when spirometric values are acceptable, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

Properties of N-acetylglucosamine 1-phosphotransferase from human lymphoblasts

Human lymphoblast and fibroblast cell lines from a patient with I-cell disease and normal individuals were characterized with respect to certain properties of UDP-N-acetylglucosamine:lysosomal enzyme precursor N-acetylglucosamine phosphotransferase. The enzyme isolated from normal lymphoblast and fibroblast cell lines expressed similar kinetic properties, substrate specificities and subcellular localizations. Coincident with the severe reduction of N-acetylglucosamine phosphotransferase activity in both I-cell fibroblast and lymphoblast cell lines, there was an increased secretion of several lysosomal enzymes compared to normal controls. Subsequent examination of N-acetyl-beta-D-hexosaminidase secreted by the I-cell lymphoblasts demonstrated a significant increase in adsorption of the I-cell enzyme to Ricinus communis agglutinin, a galactose-specific lectin. However, the I-cell lymphoblasts did not exhibit the significant decrease in intracellular lysosomal activities seen in I-cell fibroblasts. Our results suggest that lymphoblasts not only represent an excellent source for the purification of N-acetylglucosamine phosphotransferase, but in addition, represent a unique system for studying alternate mechanisms involved in the targeting of lysosomal enzymes.

Reproductive biology of flying foxes (Chiroptera: Pteropodidae)

NA

Melanin inclusions in the peripheral blood leukocytes of a patient with malignant melanoma

Dark pigmented inclusions were found in the monocytes and polymorphonuclear leukocytes of a patient with widely metastatic malignant melanoma. Special stains demonstrated the granules were composed of melanin. The authors are not aware of any previous case report of patients with metastatic malignant melanoma that had leukocytic melanin inclusions. Prospective search for this phenomenon in malignant melanoma patients may allow such a finding to be used as a diagnostic tool.

Naevoid basal-cell carcinoma syndrome with unilateral neoplasms and pits

A patient with the naevoid basal-cell carcinoma syndrome (NBCCS) is reported in whom non-aggressive neoplasms developed predominantly on the right side of the body. It is proposed that a post-zygotic somatic mutation is most likely to be responsible for the unilateral manifestation of the syndrome in this patient.

Insulin-responsive cultured foetal-rat hepatocytes. Their preparation and characterization

An improved non-perfusion method for the preparation of cultured foetal-rat hepatocytes is described. Digestion of the liver with collagenase and deoxyribonuclease I gave yields of 40 X 10(6) hepatocytes/g of liver. The plating efficiency of hepatocytes in medium with 10 microM-cortisol was 50%. Cell morphology and metabolism were maintained through 3 days of monolayer culture, with minimal contamination by haematopoietic cells or fibroblasts. The cultured cells bound and degraded 125I-insulin in a time- and dose-dependent manner. The estimated ED50 for competitive binding at 37 degrees C was 1.1 nM. Curvilinear Scatchard plots were observed, with estimates of 16 500 high-affinity sites (Kd = 813 pM) and 53 000 low-affinity sites (Kd = 23 nM) per cell. The cultured cells demonstrated a glycogenic response to insulin, with an estimated ED50 of 120 pM. The degree of glycogenic response to insulin varied with time in culture: 500% above basal on day 1, 200% on day 2, and only 150% on day 3. Cultured foetal cells also exhibited a time-dependent uptake of 2-aminoisobutyric acid, which, in contrast with previous reports with adult cells, was not stimulated by the presence of 10 nM-insulin. Cultured foetal hepatocytes may provide an interesting model with which to study the relationship between insulin-receptor binding and insulin action.

Mucolipidosis III beta-N-acetyl-D-hexosaminidase A. Purification and properties

Mucolipidosis III acid hydrolases possess an altered carbohydrate recognition marker needed for their lysosomal localization. As a result of this alteration, a portion of these enzymes is secreted from the cell to the extracellular spaces. The structural changes that may have occurred to one of these secreted enzymes, beta-N-acetyl-d-hexosaminidase A (EC 3.2.1.52) were investigated. Normal and mucolipidosis III urinary beta-N-acetyl-d-hexosaminidase A were purified to apparent homogeneity by using affinity [Sepharose-2-acetamido-N-(epsilon-aminocaproyl)-2-deoxy-beta- d-glucopyranosylamine] and ion-exchange (DEAE- and CM-cellulose) chromatography. Sodium dodecyl sulphate/polyacrylamide-slab-gel electrophoresis showed that both enzymes had similar subunit patterns consisting of apparent mol.wts. of 68000, 60000-58000, 55000 and 29000. Differences, however, were noted in the relative proportions of the protein bands where the normal urinary beta-N-acetyl-d-hexosaminidase A contained predominantly the smaller subunits, whereas the mucolipidosis III enzyme had a predominance of the larger subunits. The binding of mucolipidosis III beta-N-acetyl-d-hexosaminidase A to Ricinus communis lectin and concanavalin A with and without endo-beta-N-acetyl-d-glucosaminidase H treatment indicated that the mutation leads to a modification of a portion of the normally occurring high-mannose-type oligosaccharide units to the complex-type. This was further supported by carbohydrate compositional analysis, which revealed a mannose/galactose ratio of 2.1 for the mucolipidosis III beta-N-acetyl-d-hexosaminidase A compared with a ratio of 3.5 for the normal enzyme. Our results indicate that as a result of their inability to be properly localized to the lysosome the majority of the mucolipidosis III lysosomal hydrolase high-mannose oligosaccharide units are further processed to the complex-type before secretion of predominantly higher-molecular-weight subunits from the cell.

A study of highly purified mucolipidosis III urinary N-acetyl-beta-D-hexosaminidase B

Highly purified N-acetyl-beta-D-hexosaminidase B from normal urine and urine of a patient with mucolipidosis III was used to determine whether it has undergone any of the alterations associated with this genetic defect. Examination by sodium dodecyl sulphate/polyacrylamide gel electrophoresis showed that both the enzyme preparations contained protein components with apparent Mr values of 55 000 and 28 000. No differences in the binding and apparent KI (50%) to concanavalin A of the normal and mucolipidosis III enzymes were detected. However, the patient's N-acetyl-beta-D-hexosaminidase B had a slightly greater affinity for the lectin from Ricinus communis than did the normal enzyme. Two-dimensional tryptic peptide maps of the corresponding normal and the patient's N-acetyl-beta-D-hexosaminidase B subunits showed considerable homology. These results indicate that N-acetyl-beta-D-hexosaminidase b does not undergo the significant carbohydrate alterations characteristic of other acid hydrolases in mucolipidosis III.

Dietary survey of low-income, rural families in Iowa and North Carolina. I. Research procedures

Methods used in assessing the dietary intake of selected low-income, rural families are described. The sample consisted of 668 families randomly selected from predetermined locations in Iowa and North Carolina. A 24-hr. recall method supplemented with food models was used in gathering data on family food intake. The nutritional "adequacy" of the family diets was then evaluated according to family composition and the 1968 Recommended Dietary Allowances. The adequacy of individual nutrients was also evaluated by the same criteria. Nutrients studied included: protein, calcium, iron, vitamin A, ascorbic acid, thiamin, and riboflavin. The selection of the method in relation to opinions of previous investigators is discussed.