Probing halogen-halogen interactions in solution

Halogen-halogen interactions are a particularly interesting class of halogen bonds that are known to be essential design elements in crystal engineering. In solution, it is likely that halogen-halogen interactions also play a role, but the weakness of this interaction makes it difficult to characterize or even simply detect. We have designed a supramolecular balance that allows detecting BrBr interactions between CBr₃ groups in solution and close to room temperature. The sensitivity and versatility of the chosen platform have allowed accumulating consistent data. In halogenoalkane solvents, we propose estimates for the free energy of these weak halogen bond interactions. In toluene solutions, we show that the interactions between Br atoms and the solvent aromatic groups dominate over the BrBr interactions.

Substitution of corn and soybean with green banana fruits and Gliricidia sepium forage in sheep fed hay-based diets: effects on intake, digestion and growth

This study aimed to evaluate the substitution of imported corn and soybean by local feed resources from tropical production settings such as entire green banana and Gliricidia sepium forage as energy and protein sources, respectively, in sheep diets. Two experiments were conducted: first, a 'growth trial' and second, an in vivo digestion study. In the 'growth trial', 40 Martinik lambs [body weight (BW): 29.4 +/- 3.6 kg; 6 months old) were used and distributed into four groups of 10 lambs each according to treatment: HBGl (banana + gliricidia at low level; 1500 g/day; 119 g/kg BW(0.75)), HBGh (banana + gliricidia at high level; 3000 g/day; 238 g/kg BW(0.75)), HBS (banana + soybean cake) and Control (corn + soybean cake). In digestion trial, four Martinik rams (BW: 57.2 +/- 3.45 kg) fitted with ruminal and duodenal cannulae were used; treatments (HBG, HBS and Control) were similar but adjusted to metabolic body weight (MW) and just one level of gliricidia was used. Intake, average daily gain (ADG), feed intake to gain index (F:G), apparent total and ruminal digestibilities as well as nitrogen balance, microbial efficiency and volatile fatty acid (VFA) profile were monitored. Lambs fed HBGh had greater dry matter (DM) intake based on MW and ADG (173 g/day vs. 141 g/day; p < 0.001), whereas HBGl lambs showed the lowest ADG (71.5 g/day) and the worst F:G (14.4; p < 0.001). The DM, organic matter (OM), neutral detergent fibre and acid detergent fibre digestibilities were not influenced by treatment, whereas crude protein digestibility was higher (p = 0.024) in diets offered banana or corn + soybean cake (687 g/kg DM and 658 g/kg DM, respectively). Ruminal DM and OM digestibilities did not differ among treatments. Total or individual VFA concentrations were also not influenced by the diet. Higher (p = 0.006) ruminal fluid pH values were recorded for diets combining banana and gliricidia (6.54) or banana and soybean (6.39) until 3 h after a meal. As all animals on gliricidia- and banana-supplemented diets gained weight and maintained a positive N balance, it is concluded that green banana and gliricidia forage may be a viable alternative to replace conventional energy and protein supplements in sheep diets.

Renal retransplantation in Switzerland: poor HLA matching of first and subsequent allografts does not appear to affect overall graft survival

In Switzerland graft survival after primary renal transplantation can be considered as satisfactory, although our current policy does not favour HLA compatibility except for acute rejectors or sensitized patients. This low level of HLA matching could result in increased sensitization and affect subsequent graft survival. A total of 318 non-primary renal transplants were performed in 293 recipients during the period 1981-1990. Of these, 271 were second transplants, 40 were third transplants and seven were fourth or fifth transplants. Survival rates at 1, 2 and 5 years were 75%, 68% and 60% for second grafts, and 72%, 60% and 54% for third grafts, respectively. Results after multiple grafts were poor, but our experience was limited. The number of sensitized patients (peak PRA > 50%) awaiting retransplantation slightly increased (51 to 69), but decreased as a proportion (72% to 66%). Our policy of relying only marginally on HLA compatibility does not appear to have affected our results adversely.

Influence of psychological factors on the response to clomipramine in hospitalized chronic low back pain patients. Preliminary data from a psychometric study

BACKGROUND

Chronic low back pain is a complex condition produced by multiple factors. Psychological disturbances have been found in previous studies using a variety of psychological tests. The most widely used self-administered questionnaire was the Minnesota Multiphasic Personality Inventory (MMPI).

OBJECTIVE

To assess the response to clomipramine in chronic low back pain patients according to baseline MMPI scores.

PATIENTS AND METHODS

Thirty chronic low back pain patients were given clomipramine intravenously during a ten-day hospital stay, then orally for 20 days. The dose was gradually brought up to 150 mg/d. The MMPI was administered on the day before treatment initiation. MMPI scores were not looked at until the end of the study. The Saint Antoine Questionnaire, a visual analog scale for pain, Schöber's maneuver, and the global result as assessed by the patients (success or failure) were evaluated on days 0 (D0), 4 (D4), 10 (D10), and 30 (D30).

RESULTS

The initial mean MMPI scores for hypochondria, depression, and hysteria were significantly lower in the 23 patients (76%) who considered their treatment successful on D30. Among the 13 patients with high hypochondria and hysteria scores, five improved during hospitalization then had a relapse after returning home.

CONCLUSION

The response to treatment with clomipramine was better in nondepressive patients. The hypochondria and hysteria scores were the best predictors of the response to clomipramine. These results may provide a basis for selecting those chronic low back pain patients most likely to benefit from clomipramine therapy.

[Bronchiectasis: indication and timing for surgery]

Despite continuous improvement in the medical treatment of bronchiectasis, a number of patients will eventually require surgery. The optimal timing of surgical resection and the efficacy of surgery need to be reassessed in this context. The records of 85 patients operated for bronchiectasis during the period 1971-1991 were reviewed. Six patients underwent repeated surgical resections. Long term results could be assessed in 73 patients (86%) by means of questionnaire or subsequent medical evaluation. Indications for surgery were: persistent symptoms under medical treatment in 43 cases (51%), local complications such as fungal superinfection or severe bleeding in 17 (20%) and 11 (13%) respectively, pulmonary mass lesions in 14 (16%). Limited resections such as segmentectomies or lobectomies were carried out in 79 cases (93%). In patients with localized disease (N = 49), surgery led to significant improvement in 91% of cases. In patients with extensive or complicated disease (N = 36), long term results of surgery were satisfactory in 62% and poor in 38%; surgery was often more aggressive in this group of patients (5 pneumonectomies), and 4 postoperative deaths occurred (in debilitated patients). Patients with localized disease and recurrent symptoms despite medical treatment should be operated before the development of complications. At this stage, surgical resection can be limited and has the potential to cure or significantly improve their condition. In contrast, patients with extensive disease are often debilitated and surgical treatment is less rewarding and sometimes poorly tolerated.

Thymoma: prognostic factors

The relative importance of factors influencing prognosis and survival in the treatment of thymoma is still controversial. Fifty-three patients operated on for thymoma from 1966 to 1990 were evaluated, 14 with myasthenia gravis and 39 without. Survival was analyzed as it related to associated disease, gross invasion by the tumor and the predominant cell type. Follow-up information was obtained in all cases (mean observation time: 11.2 years). A high proportion (51%) of our patients had invasive forms (stages III and IV). The overall 5-, 10- and 20-year survival rates were 52%, 46% and 21%, respectively. Factors indicating a poor prognosis included local invasion (P < 0.0001), predominantly, epithelial histologic features (P = 0.002), tumor-related symptoms and the type of surgical procedure. Myasthenia gravis was not an adverse factor for survival. The degree of tumor invasion was the main prognostic factor and treatment should be planned accordingly.

[Impact of organ shortage on the transplantation program]

The purpose of the study was to evaluate the consequences of a recent progressive shortage of donor organs on our different transplant programs. Although the waiting time before transplantation remained in general relatively short (4.6 [mean], 0-3, 0-10 months for renal, liver and heart transplantation, respectively), patients started to accumulate on our waiting list during the last year (1990) of the study (kidney transplantation). Furthermore some patients clearly deteriorated, other died awaiting transplantation (18% and 15% of the patients listed for liver and heart transplantation, respectively). In emergency, organs were provided most often by neighbouring foreign centers. Given these facts adhesion to supranational donor networks should be considered.

[Asymptomatic mediastinal masses: prognosis, attitude and impact of thoracic radiography]

Mediastinal masses remain an interesting diagnostic and therapeutic problem for the clinician. Recent advances in imaging techniques and the increased use of chest roentgenograms in medical practice contribute to early screening of asymptomatic mediastinal masses. From 1965 to 1990, 290 patients with a primary mediastinal cyst or neoplasm were operated and treated in our institution. Among those, 80 patients presented with asymptomatic mediastinal masses. The prognosis of these asymptomatic lesions was evaluated and compared to that of symptomatic ones. Overall, two third of patients who were asymptomatic at diagnosis had a neoplasm, which proved to be malignant in half of the cases. A significantly greater number of patients with malignant neoplasms were asymptomatic at the time of diagnosis during the recent period. The prognosis of these asymptomatic lesions appeared to be better in selected tumoral types (e.g. thymomas, lymphomas) although it was difficult to completely avoid statistical bias. Early radiological detection of mediastinal tumors could improve their prognosis in selected cases. Incidental diagnosis of mediastinal masses by radiological examination should lead to early aggressive diagnostic procedure and treatment.

[Study of residual levels of delayed-action neuroleptics]

Pharmacokinetics of the depot antipsychotics are unclear and mainly depend on releasing from the depot site (according to a "flip-flop" model). Few data are available on residual plasma concentrations of those drugs. We have practiced 38 blood determinations among 15 patients treated by long-acting neuroleptics (10 by fluphenazine decanoate, 4 by flupentixol decanoate and 1 by pipotiazine palmitate). Radio Receptor Assay method was used (based on competition for dopamine receptors binding), with results expressed as chlorpromazine equivalents. They showed; a wide interindividual variability; considering each subject, intraindividual variability is attenuated; blood measurements are mainly higher than therapeutic ranges (especially for patients on fluphenazine decanoate). Those results might involve that some patients are overdosed, but other studies are needed in this way.

[Incidence of primary mediastinal lesions: change in the profile and therapeutic implications]

The pattern of occurrence of mediastinal masses has to be taken into account when treating and approaching these lesions. In most reported series tumors of neural or germinal origin and thymomas are predominant. We reviewed the records of 277 patients operated for primary mediastinal lesions over the last 25 years (1965-1989) in our center. Surprisingly (Hodgkin's and non-Hodgkin's) lymphomas (24-25%) were found to emerge as the most common tumors in our series, whereas tumor of neural (11%) and germinal (65%) origins were relatively rare and decreasing in incidence. Thymomas (17%) and mediastinal cysts (14%) occurred as predicted in the literature. Consequently the malignancy rate was high (53%) even in asymptomatic patients (18%). Similar findings have been described recently by others. Factors responsible for this new distribution are difficult to identify. The therapeutic implications of the changes are discussed.

[Pulmonary aspergilloma]

Pulmonary aspergillomas usually arise from colonization of Aspergillus in preexisting lung cavities. Between 1972 and 1988, 18 patients underwent thoracotomy for treatment of pulmonary aspergilloma in our institution. Eight patients had simple aspergilloma and ten had complex aspergilloma. Hemoptysis was the most frequent complication. Tuberculosis was the most common underlying lung disease. Patients presenting with complex aspergilloma usually had associated factors potentially reducing their immune competence. Patients with simple aspergilloma tolerated surgery quite well and the outcome was satisfactory. By contrast operative mortality was 30% (3 deaths) in patients with complex aspergilloma and complications occurred in 8 patients (80%). Treatment of pulmonary aspergilloma must be individualized to take into account the patient's overall health and the risks attendant with each treatment modality.

[Elaboration of an ethogram for the diagnosis of the A Pattern in coronary pathology]

In order to develop a technique which allows the detection of Pattern A (PA) we present in this paper a series of steps for constructing an observation gril (ethogram) which allows for the quantification of behavior in situation of structured interview. The behavioral units making up the final ethogram are derived from inter-item correlations taken from a population of 48 subjects who had suffered heart attacks. The observations on this population permit an inclusion score in the PA. These observations also confirm that the PA present a risk factor which is independent of classical risk factors. A significative positive correlation with work stress has been found showing, in accordance with the view of Friedman and Rosenman that the PA corresponds to a particular behavioral pattern which is dependent on the work environment.

[Elaboration of an ethogram for the diagnosis of Pattern "A"]

In order to develop a technique which allows the detection of Pattern A (P.A.) we present in this paper a series of steps for constructing an observation grill (ethogram) which allows for the quantification of behavior in situation of structured interview. The behavioral units making up the final ethogram are derived from inter-item correlations taken from a population of 48 subjects who had suffered heart attacks. The observations on this population permit an inclusion score in the P.A. These observations also confirm that the P.A. present a risk factor which is independent of classical risk factors. A significative positive correlation with work stress has been found showing, in accordance with the view of Friedman and Rosenman that the P.A. corresponds to a particular behavioral pattern which is dependent on the work environment.

[Surgical treatment of pulmonary metastases]

From 1973 to 1988, 58 patients underwent operation for pulmonary metastases in our institution. The operative mortality was low (1-2%). The primary tumor was a melanoma in 7 cases, a sarcoma in 7 cases and a carcinoma in the remaining 44 cases. The overall 5-year patients survival was 30% and compares favorably with other series. Radical surgical excision significantly affects survival. Repeated or bilateral surgical excisions are sometimes needed. With the increased effectiveness of chemotherapy the role of surgery is changing. Surgical treatment of pulmonary metastases is indicated in selected cases.

Sequential determinations of urinary cytology and plasma and urinary lymphokines in the management of renal allograft recipients

Urine cytology, plasma (P), and urinary (U) interleukin-2 (IL-2)* and IL-2 receptor (IL-2R) levels were evaluated as immunological monitoring techniques in 65 renal allograft recipients. Normal individuals showed normal urine cytology, IL-2(U) = 0, IL-2(P) = 0.4 +/- 0.1 ng/ml (mean +/- SEM) and IL-2R(P) = 318 +/- 26 U/ml. Stable transplants also showed normal urine cytology, no IL-2(U), IL-2(P) = 0.8 +/- 0.2 ng/ml, and IL-2R(P) = 326 +/- 29 U/ml. Rejection episodes (n = 21) were accompanied by cytologic changes, including lymphocyturia, exfoliation of immature tubular cells, platelet aggregates, and fibrin deposits. The corresponding lymphokine changes were IL-2(U) = 39.6 +/- 1.4 ng/ml, IL-2(P) = 79 +/- 21 ng/ml, and IL-2R = 1884 +/- 202 U/ml, all markedly increased. Successful treatment was associated with return of all parameters to normal; treatment failure was associated with continued abnormalities. Fourteen rejections unresponsive to Solumedrol (500 mg x 5 days) required OKT3 rescue (5 mg x 14 days). In the 11 that were reversed, onset of OKT3 therapy was characterized by markedly increased exfoliation of necrotic cellular debris, lymphocytes, and collecting duct cells. Interestingly, serum creatinine increases of 57.2 +/- 18.9% (range 25-90%) over pre-OKT3 levels were noted. Maximal changes occurred 48-72 hr after the first dose, followed by gradual return to normal. Rejections unresponsive to OKT3 (n = 3) showed no cytologic changes from the pretreatment mean creatinine increase of 13.2 +/- 2.7% (range 9-15%), and maximum change occurred 24 hr after the first dose. Rejections responsive to Solumedrol only (n = 4) showed gradual improvement of all parameters. Rejections treated with Solumedrol following failed OKT3 prophylaxis (n = 3) did not reverse and continued to show rejection associated cytologic changes and abnormal creatinines. Patients experiencing CsA toxicity (n = 12) showed mild creatinine elevations, normal or negative IL-2(P) and IL-2R(P) levels, and no IL-2(U). They showed distinctive cytologic changes consisting of swollen convoluted tubular cells with nuclear pyknosis and cytoplasmic vacuoles. Pretransplant IL-2(P) levels of patients who subsequently rejected were elevated, with 19/21 patients with preoperative IL-2 levels greater than 15 ng/ml having subsequent rejections. In contrast, pretransplant creatinine, urine cytology, and IL-2(U) levels showed no correlation to subsequent clinical course.(ABSTRACT TRUNCATED AT 400 WORDS)

Characterization of peptides cleaved by plasmin from the C-terminal polymerization domain of human fibrinogen

The C-terminal region of the fibrinogen gamma chain is known to participate in several functional interactions including fibrin polymerization. This part of the molecule is retained on the gamma chain of fragment D (FgD) when fibrinogen is digested by plasmin in the presence of calcium to produce the fragment D-fragment E (FgD X FgE) complex but is lost if FgD is prepared in the absence of calcium. In an attempt to characterize the C-terminal polymerization domain we have used three techniques to examine this further degradation of FgD following the addition of EDTA and plasmin. Analysis of the digestion by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed a progressive cleavage of the gamma chain to two small remnants. The polymerization-inhibitory activity of the whole digest was studied using acid-solubilized fibrin. A progressive loss of inhibitory activity was associated with gamma chain shortening, reaching greater than a 120-fold reduction at the end of digestion. The cleavage of peptides was followed by reverse-phase high performance liquid chromatography and the release of a characteristic peptide triplet was associated with gamma chain cleavage. Manual sequencing, amino acid analysis, and fast atom bombardment mass spectrometry established the three peptides as gamma 303-356, 357-373, and 374-405. These peptides have sequences in common with those peptides recently reported by other investigators to be potent polymerization inhibitors. However, when a mixture of the three peptides was added in a 200-fold molar excess to polymerizing fibrin, no inhibitory activity could be demonstrated. It is concluded that the C-terminal polymerization domain of fibrinogen may be an extended region which includes the sequence gamma 303-405, when this is contiguous with the remainder of the gamma chain.

The myotropic and plasma-calcium modulating effects of calcitonin gene-related peptide (CGRP)

Human and rat calcitonin gene-related peptides cause a dose-related contraction of guinea pig ileum, which is antagonised by an anti-histamine, mepyramine, and an anticholinergic compound, hyoscine. Both peptides also cause a positive inotropic and a positive chronotropic effect in the rat isolated auricle and these responses are antagonised by propranolol, a B adrenoceptor blocker. Further, the peptides lower plasma calcium levels in both rats and rabbits in a dose-related manner resembling calcitonin; in the rabbit, but not in the rat, the initial calcium lowering effect is succeeded by hypercalcaemia at higher doses, while in the chick, only the parathyroid hormone-like calcium-raising effect is seen.

Isolation and characterization of human calcitonin gene-related peptide

The rat calcitonin gene has recently been shown to encode a novel peptide (rat calcitonin gene-related peptide, rCGRP) thought to be produced in nervous tissue after tissue-specific RNA processing. This peptide has so far been identified only in rat tissue, by immunocytochemistry and immunoassay. We now report the isolation of a related (89% homology) peptide from human tissue (hCGRP) which we have sequenced using a novel mass spectrometric approach, fast atom bombardment (FAB) mapping. The human peptide differs significantly from the predicted rCGRP structure in four positions in the amino acid sequence (three effecting charge changes), and the presence of a disulphide bridge and an amide, surmised in the rat work, is proven in the hCGRP molecule. hCGRP was present in plasma from 10 patients with medullary thyroid carcinoma (MTC) and in 6 MTC tumours removed at surgery, suggesting the tissue distribution may differ from that in the rat where the peptide is reported to be absent from thyroid tissue. hCGRP is shown to have biological activity and it is possible that its presence in MTC plasma may be responsible for some of the symptoms in this disease.

Characterisation of an adrenal zona glomerulosa-stimulating component of posterior pituitary extracts as alpha-MSH

The secretion of aldosterone from the zona glomerulosa of the mammalian adrenal cortex is stimulated by ACTH, potassium, angiotensin II and III, growth hormone, serotonin and E series prostaglandins. Some experimental and clinical studies suggest that additional stimulants of the zona glomerulosa must exist, possibly including pituitary factors other than ACTH. The possibility that posterior pituitary extracts may contain a zona glomerulosa stimulant was first suggested 20 years ago, but has since received little attention. We describe here the purification from posterior pituitary extracts of activities that stimulate rat glomerulosa cells and whole tissue in vitro. One of the active compounds has been identified as alpha-MSH (melanocyte stimulating hormone).

[Electrogastroenterographic study of the digestive motor effects of prolonged psychotropic treatment]

Functional digestive complaints are frequent in psychiatri patients: simple constipation, which cannot be explained solely by the loss of the sensation of rectal fullness; occlusions, occasionally hemorragies; the late complication of dolichomegacolon (Bourgeois, 1973). In 160 subjects, an attempt to understand the physio-pathology were made by recording diurnal digestive motor activity using skin electrodes placed on the abdomen and extremities (electrogastroenterography or E.G.E.G.). A hypoactive E.G.E.G. was observed in 2/3 of 18 psychotic depressive patients, in 3/4 of 36 schizophrenies. The nocive effect of giving sedative phenothiazine and antiparkinsonian drugs (trihexyphenidyl or ethybenzatropine) during long periods is clear. Whereas non sedative phenothiazine and clotiapine gicen in small doses, do not have an undesirable effect. Sulpiride has been used in gastroduodenal dyskinesia. The dyskinesia noted by the E.G.E.G., sometimes found in the large intestin, were found in 55% of 30 patients with caracter disorders; they coincide with the high frequency of electro-encephalogram dysrythmies. Finally, in hysterical patients, one usually observes normal E.G.E.G., tracings which confirms the clinical observation that hysterical and psychosomatic symptoms, may succeed each other, but do not appear at the same time. In the same categories of patients, no longer treated in a classical psychiatric environment but in a group with institutional objectives, the same clinic results were obtained with fewer digestive disturbances. This tends to show the inutility and nocivity of excessive doses of psychotropic drugs given alone or in complexe association.

[Diagnosis of human active or latent human brucellosis by lymphocyte transformation. Inhibition of leukocyte migration and passive hemagglutination. Possible interference between brucellosis and some mental disorders]

Passive hemagglutination tests (H.T.), involving the coating of a soluble B. abortus antigen onto sheep red blood cells through chromium chloride, were always negative in non-brucellic subjects. Positive H.T., even at low titers (1:50), were associated with positive specific lymphoblastic (T.T.L.) and inhibition of leucocyte migration (I.M.L.) tests in 13 patients. These 3 tests were negative in 17 control brucellosis-free individuals. Positive H.T. confirmed a clinical diagnosis of brucellosis in 27 patients with dubious or negative responses to classical tests. Low positive (1:50, 1:100) H.T. may correspond to Brucella primary-infection or to a quiescent chronic infection, and higher titers to clinically active brucellosis. There is a correlation between cellular immunity tests (T.T.L., I.M.L.) and passive hemagglutination test. Furthermore, 39/88 women hospitalized in psychiatric wards were positive to H.T., and 6 of them were also highly positive to complement fixation and tube agglutination tests. Three T.T.L. and I.M.L., performed on samples from 3 H.T. (1:50) positive patients, were positive. These 30 patients were classified as depression or severe anorexia.