Photonic crystal nanostructures for optical biosensing applications

We present the design, fabrication and optical investigation of photonic crystal (PhC) nanocavity drop filters for use as optical biosensors. The resonant cavity mode wavelength and Q-factor are studied as a function of the ambient refractive index and as a function of adsorbed proteins (bovine serum albumin) on the sensor surface. Experiments were performed by evanescent excitation of the cavity mode via a PhC waveguide. This in turn is coupled to a ridge waveguide that allows the introduction of a fluid flow cell on a chip. A response of partial delta lambda/delta c=(4.54+/-0.66)x10(5)nm/M is measured leading to a measured detection limit as good as Delta m=4.0+/-0.6 fg or Delta m/Delta A=(4.9+/-0.7)x10(2)pg/mm(2)in the sensitive area.

Comparing oxalic acid and sucrocide treatments for Varroa destructor (Acari: Varroidae) control under desert conditions

The effectiveness of oxalic acid (OA) and Sucrocide (S) (AVA Chemical Ventures, L.L.C., Portsmouth, NH) in reducing populations of the varroa mite Varroa destructor Anderson & Trueman (Acari: Varroidae) in honey bee, Apis mellifera L. (Hymenoptera: Apidae) colonies was measured under the desert conditions of Arizona, USA. OA and S were applied three times 7 d apart. A 3.2% solution of OA was applied in sugar syrup via a large volume syringe, trickling 5 ml per space between frames in the colony. S was applied at a concentration of 0.625% (mixed with water), according to the label directions, using a compressed air Chapin sprayer at 20 psi to apply 59 ml per frame space. Varroa mites, collected on a sticky board before, during, and after the treatments, were counted to assess the effectiveness of the treatments. This study showed that a desert climate zone did not confer any positive or negative results on the acaricidal properties of OA. Even with brood present in colonies, significant varroa mite mortality occurred in the OA colonies. In contrast, we found that Sucrocide was not effective as a mite control technique. Despite its ability to increase mite mortality in the short-term, varroa mite populations measured posttreatment were not affected any more by Sucrocide than by no treatment at all.

Fine needle aspiration cytology of mammary duct ectasia: report of a case with novel cytologic and immunocytochemical findings

BACKGROUND

Mammary duct ectasia (MDE), or periductal mastitis, is a well-defined clinical entity with a characteristic histopathologic appearance on breast biopsy specimens. However, the cytologic features of MDE have been described only recently in the cytopathology literature, and fine needle aspiration (FNA) cytologic findings are based mainly on a small number of case reports in the English-language literature. Therefore, awareness of this entity and recognition of its cytomorphologic features could aid in a more accurate diagnosis. We report the novel cytologic and immunocytochemical findings on a case of MDE that was confirmed by histologic examination on a subsequent biopsy.

CASE

We report the findings of breast FNA cytology in a 50-year-old female with a mammographically and clinically suspicious lesion. Cytology displayed a paucicellular aspirate, typified by a few scattered, cohesive clusters of ductal epithelial cells with mild nuclear atypia and distinct, peripherally located myoepithelial cells. Intermingled within the ductal elements were numerous polygonal cells with abundant, finely vacuolated cytoplasm that were immunoreactive for macrophage-specific antibody, CD68. The background consisted of a variable number of foam cells and negligible amount of blood.

CONCLUSION

The current case of MDE demonstrates cytomorphologic features that may pose diagnostic problems, particularly as a consequence of variable cytologic atypia this entity may present on FNA cytology. This diagnostic difficulty is compounded because of the abnormal mammographic and suspicious clinical findings that may be associated with MDE. CD68 immunoreactivity is a useful ancillary tool to verify the histiocytic, rather than epithelial and potentially neoplastic, nature of multivacuolated cells. To the best of our knowledge, there has been no prior reported case of MDE in the English-language literature studied utilizing CD68 antibody. This case report emphasizes that MDE is a heterogeneous entity with diverse cytomorphologic features. FNA cytology in conjunction with immunocytochemistry might permit accurate classification in the proper clinical setting.

Overexpression of a modified human malonyl-CoA decarboxylase blocks the glucose-induced increase in malonyl-CoA level but has no impact on insulin secretion in INS-1-derived (832/13) beta-cells

The long-chain acyl-CoA (LC-CoA) model of glucose-stimulated insulin secretion (GSIS) holds that secretion is linked to a glucose-induced increase in malonyl-CoA level and accumulation of LC-CoA in the cytosol. We have previously tested the validity of this proposal by overexpressing goose malonyl-CoA decarboxylase (MCD) in INS-1 cells, but these studies have been criticized due to: 1) the small insulin secretion response (2-4-fold) of the INS-1 cells used; 2) unknown contribution of the ATP-sensitive K(+) (K(ATP)) channel-independent pathway of GSIS in INS-1 cells, which has been implicated as the site at which lipids regulate insulin granule exocytosis; and 3) deletion of the N-terminal mitochondrial targeting sequence, but not the C-terminal peroxisomal targeting sequence in the goose MCD construct, raising the possibility that a significant fraction of the overexpressed enzyme was localized to peroxisomes. To address these outstanding concerns, INS-1-derived 832/13 cells, which exhibit robust K(ATP) channel-dependent and -independent pathways of GSIS, were treated with a new adenovirus encoding human MCD lacking both its mitochondrial and peroxisomal targeting sequences (AdCMV-MCD Delta 5), resulting in large increases in cytosolic MCD activity. Treatment of 832/13 cells with AdCMV-MCD Delta 5 completely blocked the glucose-induced rise in malonyl-CoA and attenuated the inhibitory effect of glucose on fatty acid oxidation. However, MCD overexpression had no effect on K(ATP) channel-dependent or -independent GSIS in 832/13 cells. Furthermore, combined treatment of 832/13 cells with AdCMV-MCD Delta 5 and triacsin C, an inhibitor of long chain acyl-CoA synthetase that reduces LC-CoA levels, did not impair GSIS. These findings extend our previous observations and are not consistent with the LC-CoA hypothesis as originally set forth.

A sequential sampling scheme for detecting infestation levels of tracheal mites (Heterostigmata: Tarsonemidae) in honey bee (Hymenoptera: Apidae) colonies

The introduction of parasitic honey bee mites, the tracheal mite, Acarapis woodi (Rennie) in 1984 and the Varroa mite, Varroa jacobsoni, in 1987, has dramatically increased the winter mortality of honey bee, Apis mellifera L., colonies in many areas of the United States. Some beekeepers have minimized their losses by routinely treating their colonies with menthol, currently the only Environmental Protection Agency-approved and available chemical for tracheal mite control. Menthol is also expensive and can interfere with honey harvesting. Because of inadequate sampling techniques and a lack of information concerning treatment, this routine treatment strategy has increased the possibility that tracheal mites will develop resistance to menthol. It is important to establish economic thresholds and treat colonies with menthol only when treatment is warranted rather than treating all colonies regardless of infestation level. The use of sequential sampling may reduce the amount of time and effort expended in examining individual colonies and determining if treatment is necessary. Sequential sampling also allows statistically based estimates of the percentage of bees in standard Langstroth hives infested with mites while controlling for the possibility of incorrectly assessing the amount of infestation. On the average, sequential sampling plans require fewer observations (bees) to reach a decision for specified probabilities of type I and type II errors than are required for fixed sampling plans, especially when the proportion of infested bees is either very low or very high. We developed a sequential sampling decision plan to allow the user to choose specific economic injury levels and the probability of making type I and type II errors which can result inconsiderable savings in time, labor and expense.

Paucity of CFTR current but modest CFTR immunoreactivity in non-diseased human ventricle

We looked for evidence of expression of the cystic fibrosis transmembrane conductance regulator (CFTR) in non-diseased human ventricle. In rabbit and guinea pig the CFTR current is present in the highest density in subepicardial ventricular myocytes. In the present study, whole-cell patch-clamp was used to determine if a CFTR-like chloride current (I(CFTR,card)) can also be activated in human subepicardial ventricular myocytes. No evidence for I(CFTR,card) was detected in these electrophysiological studies when 10 microM forskolin was applied to 23 different cells from 4 donor hearts. Consistent with our previous results, a swelling-induced chloride current (I(Cl,swell)) could be observed after cell inflation. The enzymatic digestion of human ventricle to release single myocytes may have affected our ability to detect I(CFTR,card). Therefore, we looked for anti-CFTR immunoreactivity in slices of left ventricular free wall. A strong immunoreactivity signal was observed in guinea pig ventricle, a positive control. Background staining levels were seen in dog ventricle, a negative control tissue. Human anti-CFTR immunoreactivity was slightly above background. This low level of anti-CFTR immunoreactivity is consistent both with reports that CFTR mRNA is detectable in human ventricle and our inability to detect a significant I(CFTR,card) current density.

Simultaneous X-Ray and TeV Observations of a Rapid Flare from Markarian 421

Mrk 421 was observed for about 2 days with BeppoSAX in 1998 April as part of a worldwide multiwavelength campaign. A large, well-defined flare was observed in X-rays. The same flare was observed simultaneously at TeV energies by the Whipple Observatory gamma-ray telescope. These data provide (1) the first evidence that the X-ray and TeV intensities are well correlated on timescales of hours and (2) the first exactly simultaneous X-ray and TeV spectra. The results imply that the X-ray and TeV photons derive from the same region and from the same population of relativistic electrons. The physical parameters deduced from a homogeneous synchrotron self-Compton model for the spectral energy distribution yield electron cooling times close to the observed variability timescales.

Natural history and surgical outcomes for isolated discrete subaortic stenosis in children

OBJECTIVE

To document the natural history and surgical outcomes for discrete subaortic stenosis in children.

DESIGN

Retrospective review.

SETTING

Tertiary care paediatric cardiology centres.

PATIENTS

92 children diagnosed between 1985 and 1998.

MAIN OUTCOME MEASURES

Echocardiographic left ventricular outflow gradient (echograd), and aortic insufficiency (AI).

RESULTS

The mean (SEM) age at diagnosis was 5.3 (0.4) years; the mean echograd was 30 (2) mm Hg, with AI in 22% (19/87) of patients. The echograd and incidence of AI increased to 35 (3) mm Hg and 53% (36/68) (p < 0.05) 3.6 (0.3) years later. The echograd at diagnosis predicted echograd progression and appearance of AI. 42 patients underwent surgery 2.2 (0.4) years after diagnosis. Preoperatively echograd and AI incidence increased to 58 (6) mm Hg and 76% (19/25) (p < 0.05). The echograd was 26 (4) mm Hg 3.7 (0.4) years postoperatively, with AI in 82% (31/38) of patients. Surgical morbidities included complete heart block, need for prosthetic valves, and iatrogenic ventricular septal defects. Eight patients underwent reoperation for recurrent subaortic stenosis. The age at diagnosis of 44 patients followed medically and 42 patients operated on did not differ (5.5 (0.6) v 5. 0 (0.6) years, p < 0.05). However, the echograd at diagnosis in the former was less (21 (2) v 40 (5) mm Hg, p < 0.05) and did not increase (23 (2) mm Hg) despite longer follow up (4.1 (0.4) v 2.2 (0. 4) years, p < 0.05). The incidence of AI at diagnosis and at last medical follow up was also less (14% (6/44) v 34% (13/38); 40% (17/43) v 76% (19/25), p < 0.05).

CONCLUSIONS

Many children with mild subaortic stenosis exhibit little progression of obstruction or AI and need not undergo immediate surgery. Others with more severe subaortic stenosis may progress precipitously and will benefit from early resection despite risks of surgical morbidity and recurrence.

Hydrophobic benzoic acids as inhibitors of influenza neuraminidase

Neuraminidase (NA) plays a critical role in the life cycle of influenza virus and is a target for new therapeutic agents. A new benzoic acid inhibitor (11) containing a lipophilic side chain at C-3 and a guanidine at C-5 was synthesized. The X-ray structure of 4-(N-acetylamino)-5-guanidino-3-(3-pentyloxy)benzoic acid in complex with NA revealed that the lipophilic side chain binds in a newly created hydrophobic pocket formed by the movement of Glu 278 to interact with Arg 226, whereas the guanidine of 11 interacts in a negatively charged pocket created by Asp 152, Glu 120 and Glu 229. Compound 11 was highly selective for type A (H2N2) influenza NA (IC50 1 microM) over type B (B/Lee/40) influenza NA (IC50 500 microM).

Potent inhibition of influenza sialidase by a benzoic acid containing a 2-pyrrolidinone substituent

On the basis of the lead compound 4-(N-acetylamino)-3-guanidinobenzoic acid (BANA 113), which inhibits influenza A sialidase with a Ki of 2.5 microM, several novel aromatic inhibitors of influenza sialidases were designed. In this study the N-acetyl group of BANA 113 was replaced with a 2-pyrrolidinone ring, which was designed in part to offer opportunities for introduction of spatially directed side chains that could potentially interact with the 4-, 5-, and/or 6-subsites of sialidase. While the parent structure 1-(4-carboxy-2-guanidinophenyl)pyrrolidin-2-one (8) was only a modest inhibitor of sialidase, the introduction of a hydroxymethyl or bis(hydroxymethyl) substituent at the C5' position of the 2-pyrrolidinone ring resulted in inhibitors (9 and 12, respectively) with low micromolar activity. Crystal structures of these inhibitors in complex with sialidase demonstrated that the substituents at the 5'-position of the 2-pyrrolidinone ring interact in the 4- and/or 5-subsites of the enzyme. Replacement of the guanidine in 12 with a hydrophobic 3-pentylamino group resulted in a large enhancement in binding to produce an inhibitor (14) with an IC50 of about 50 nM against influenza A sialidase, although the inhibition of influenza B sialidase was 2000-fold less. This represents the first reported example of a simple, achiral benzoic acid with potent (low nanomolar) activity as an inhibitor of influenza sialidase.

Testing the Uniform Needs Assessment Instrument for hospital discharge planning with older adults

The Uniform Needs Assessment Instrument (UNAI) was developed to systematically assess the continuing care needs of high-risk older adults in response to the 1986 Omnibus Budget Reconciliation Act. Based on previous studies, a revised UNAI was tested with 103 hospitalized older adults, comparing usual discharge planning with the UNAI. High interrater reliability was obtained. The UNAI had high (> or = 85%) sensitivity and specificity when comparing needs identification on the UNAI with subjects' reported needs at 10 to 14 days after discharge. Overall, the UNAI was more effective (sensitive and specific).

Single lead VDD pacing in children with complete heart block

OBJECTIVE

To evaluate clinically transvenous single lead VDD pacing in children with complete heart block.

DESIGN

Case series.

SETTING

Tertiary care unit of a pediatric teaching hospital.

PATIENTS

Consecutive sample of children with complete heart block requiring pacing and meeting the criteria for VDD pacing.

INTERVENTIONS

VDD single lead pacing systems (Thera VDD 8948 generator, Capsure VDD 5032 single pass lead) were implanted in nine children (mean age 10.7 years, 95% CI 8.9 to 12.3). All patients were reviewed six weeks and six months post-implantation with clinical review, detailed pacemaker interrogation, optimal device programming, treadmill exercise testing, 24 h Holter monitoring and echocardiography.

RESULTS

Mean procedure time was 62.5 mins (CI 52 to 73), mean fluoroscopy time 3.8 mins (CI 2.4 to 5.1) and mean P wave sensing amplitude 2.75 mV (CI 2.5 to 3), without significant decrease during Valsalva manoeuvre (mean 2.4 mV, CI 2.2 to 2.8). Low pacing thresholds of mean amplitude 0.39 V (CI 0.38 to 0.4) were established at pulse width 0.5 ms. Two patients required early revision--one lead dislodged and one patient had a loose set screw. Follow-up showed satisfactory pacemaker function, and mean percentage atrioventricular (AV) synchronous pacing 96.8% (CI 93 to 99) at six weeks and 97% (CI 95 to 99) at six months. P wave sensing failures were less than 1%. AV synchronous pacing was maintained for more than 99% of the period of treadmill exercise testing. There was a significant mean increase in cardiac output of 24% (CI 8 to 40, P < 0.05) at rest in VDD mode compared with VVIR mode.

CONCLUSIONS

Single lead VDD pacing is an effective and reliable method of 'physiological' rate responsive AV synchronous pacing in children with complete heart block and should be considered a viable alternative to dual lead pacing systems.

Single-tooth implant-supported restorations in the anterior maxilla

With the development of advanced surgical techniques, implants can now be utilized in a variety of applications, including replacement of a single tooth. The form of an artificial restoration is determined by the existing tooth morphology and periodontal architecture; when placing single-tooth implants, the original structure of the tooth and periodontium must be recreated. Osseointegrated single-tooth implants have a success rate that is comparable to that of implant-supported prostheses in totally edentulous patients; a 98.5% success rate has been reported following 3 years in situ. The learning objective of this article is to gain an understanding of pretreatment guidelines, such as soft tissue considerations, bone dimension, root morphology, and site preparation with osteotomes for single-tooth implant placement. The review also includes the discussion of the placement of single-tooth implants, flap design, prosthetic considerations, and the final restoration. Two case reports are presented to document and illustrate the clinical procedure.

NMR applications in complex food systems

The rheological and functional properties of food components are related to their molecular structure, morphology, and atomic mobilities. NMR provides a powerful tool for elucidating chemical structures, molecular conformations, and interactions of components in food systems. Quantitative analysis of sugars, fats, and other principal compounds in complex food systems was achieved by high-resolution liquid NMR. In addition to information available from liquid experiments, solids NMR experiments can reveal differences and changes in crystal packing of structures in food model systems. Interpretation of experimental results is enhanced by molecular modeling of key food compounds. Models for fat crystallization are carried out to enhance understanding of the molecular structures involved in the fat crystallization process. Recently, MRI has also shown significant impact on food science and technology. Some examples of NMR applications are given in this presentation.

Clinical significance of human parvovirus B19 infection in pregnancy

We present a case of human parvovirus B19 infection in a term pregnancy that resulted in rapid development of hydrops fetalis and death. Clinical aspects of this virus in pregnancy and therapeutic options are discussed.

Prenatal diagnosis of cerebellar hemorrhage: medicolegal implications

Perinatal brain damage and compromised long-term neurologic outcome have been a topic of major concern and continuing debate. Until recently the occurrence of fetal brain injury was attributed to intrapartum events. However, evidence continues to accumulate that neurologic damage can occur during fetal life unrelated to intrapartum events. We report a case of massive cerebellar hemorrhage of unknown cause diagnosed by ultrasonography at 36 weeks of gestation after decreased fetal movements. Fetal heart rate pattern and Doppler flow study of cerebral arteries are correlated with neuropathologic findings, and the medicolegal aspects of this condition are discussed.

Human antibodies reactive with beta-amyloid protein in Alzheimer's disease

Four human B cell lines established by Epstein-Barr viral transformation of B cells from a patient with a clinical diagnosis of Alzheimer's disease (AD) were found to secrete antibodies that react with plaques and cerebrovascular blood vessels in AD brain in a staining profile characteristic of beta-amyloid protein (beta-AP) in AD brain. Two of these antibodies were shown to be reactive with a rare plaque in a normal brain. In these studies, immunofluorescence and avidin-biotin complex immunoperoxidase methodology were used to determine antibody reaction, and thioflavine S was used to double label amyloid and neurofibrillary tangles. The four antibodies also reacted with neurons in normal and AD brain. Absorption studies, dot immunoblots, and enzyme-linked immunosorbent assays with beta-amyloid peptides 1-28 (beta-A1-28) and 1-40 (beta-A1-40) indicate the major determinant of the reactive epitope is located in the region of amino acids 1-28 of beta-AP. However, inhibition studies demonstrate a significant contribution to the antigenic determinant by the 29-40 region of the beta-A1-40. These antibodies represent the first human autoantibodies against beta-AP. The pathological significance of these autoantibodies is discussed.

Placental chorioangioma: prenatal diagnosis and clinical significance

We report the prenatal diagnosis of placental chorioangioma in a 32-week intrauterine pregnancy associated with polyhydramnios and enlarged fetal cardiac size that resulted in intrauterine fetal death. Ultrasound appearance, pathophysiology, and clinical significance of this entity are discussed.

Surgically created Wolff-Parkinson-White syndrome after Fontan operation

The Wolff-Parkinson-White syndrome is caused by a congenital accessory connection between the atrium and ventricle. We describe a case of symptomatic Wolff-Parkinson-White syndrome that arose after a Björk modification of the Fontan operation. Invasive electrophysiologic and intraoperative mapping indicated that the surgically created atrioventricular connection was functioning as an accessory pathway. Surgical dissection and cryoablation abolished the symptoms and the preexcitation.

Posttranslational modifications of rat proenkephalin overexpressed in Chinese hamster ovary cells

Rat proenkephalin was overexpressed in Chinese hamster ovary cells using the dihydrofolate reductase-coupled genetic amplification method. About 2 mg purified protein could be obtained from 250 ml conditioned medium; multiple successive harvests could be obtained from the same roller bottle. Degradation of proenkephalin released into the conditioned medium was reduced significantly in the presence of 2% fetal bovine serum. Forty-eight percent of recombinant proenkephalin was glycosylated; glycosylation could be entirely prevented by the addition of tunicamycin. Two-dimensional isoelectric focusing experiments showed that recombinant proenkephalin exhibited considerable charge heterogeneity, with two major unglycosylated isoelectric forms and six or seven glycosylated isoelectric forms. The estimated isoelectric points of the major unglycosylated proenkephalins were 6.0 and 6.1, while glycosylated proenkephalins ranged in pI from 5.7-6.1. Some of this isoelectric heterogeneity is due to phosphorylation; [32P] orthophosphate was readily incorporated into serine residues within newly synthesized proenkephalin.

Stretch syncope in adolescence

We describe 6 adolescents with syncope induced by stretching with the neck hyperextended. Studies of the cardiovascular responses to stretching and Valsalva in these patients were the same as controls, indicating that the mechanism is not simply Valsalva but may also involve vertebral artery compression coupled with a familial tendency to faint.

Clinical correlations of antibodies that bind, block, or modulate human acetylcholine receptors in myasthenia gravis

Acetylcholine receptor (AChR) binding and AChR modulating antibodies were found with approximately the same frequency (86%) in 349 patients with myasthenia gravis (MG). However, the total yield of positive serological results was significantly improved (90%) by assaying AChR modulating antibodies when AChR binding antibodies were not detected, because in 27 patients (8%) only one of the two tests was positive. The immunoprecipitation test for AChR blocking antibodies yielded fewer positive results (52%), but there was a significant correlation between the degree of AChR blockade and generalization of muscle weakness. In no patient was this the only positive test, because the test for AChR modulating antibodies in this study detected both AChR blocking and modulating antibodies. Human muscle AChR was used as antigen in all tests. False positive results were rare and were attributed to unexplained antibodies to 125I-alpha-Bgt (AChR binding antibody assay) and recent general anesthesia using muscle relaxants (AChR blocking and AChR modulating antibody assays). Unexplained positive results, documented previously in 5% of patients with the Lambert-Eaton myasthenic syndrome and amyotrophic lateral sclerosis (ALS), were found in this study in two of 22 patients with ALS, but in none of 427 patients with miscellaneous neurological diseases. Patients with severe generalized MG and/or thymoma tended to have higher titers of AChR binding antibodies and greater AChR modulating antibody activity. However, some patients with severe muscle weakness had low titers of antibodies, and some patients in remission or with only ocular manifestations had high titers. These seemingly paradoxical results reflect heterogeneity in the specificities, affinities, and isotypes of anti-AChR antibodies. To effect pathogenicity, antibodies must have access in vivo to extracellular antigenic sites on the AChR. One would anticipate that antibodies with greatest pathophysiological potential would be of an IgG with greatest pathophysiological potential would be of an IgG subclass that activates complement, or of a specificity that competes for acetylcholine's binding site on the receptor or readily cross-links two AChR molecules to trigger receptor modulation (e.g., by binding to sites on the duplicated alpha-subunit). In patients with suspected MG who lack serological evidence of anti-AChR antibodies, motor endplate biopsy is required for microelectrophysiological, immunochemical, and ultrastructural studies to establish with certainty whether or not the condition is acquired MG.

Screening of subsequent siblings of children who die of sudden infant death syndrome

Since the value of home apnea monitoring for subsequent siblings (subsibs) of an infant who died of sudden infant death syndrome is uncertain, we describe an evaluation and monitoring program for subsibs. Eighty subsibs were screened in hospital at an average age of 4.6 weeks. The most valuable investigations included history, physical examination, blood gas tests, and four days on an apnea monitor in hospital. Sleep recordings added no decision-making data. Only 23 infants met one of the following criteria for home apnea monitoring: (1) sleep apnea for more than 15 s (either on sleep recording or recognized by apnea alarm), (2) more than 4.5 episodes of apnea per hour of sleep, (3) periodic breathing greater than 24% of sleep time, or (4) severe parental anxiety. Twenty-two infants were monitored until they were aged 6 months and had spent two months apnea free. Twelve had apnea at home. All of the infants survived. Excessive periodic breathing alone did not seem to be a valid reason for home monitoring. Our screening program is simple, acceptable to families, and useful to select a smaller number of subsibs for home apnea monitoring.

Immunological probes for oestradiol receptors in human breast tumours

Monoclonal antibodies have been prepared against a soluble oestradiol receptor (REC) preparation partially purified from human myometrium by oestradiol affinity chromatography. The antibodies were detected by their ability to immunoprecipitate receptor bound [125I] oestradiol. One of the antibodies (D5) has been studied in detail. It will only precipitate REC after activation by salt, heat, low pH or KCNS and will not react with nuclear RE. It will not react with androgen, progesterone or glucocorticoid receptors nor with sex hormone binding globulin; it will only combine with REC from human sources. D5 recognizes a cytoplasmic 29 kdalton protein (p29) that can be separated from both type I and II soluble oestradiol binding proteins. p29 can react with activated REC and is qualitatively and quantitatively related to REC. IRMA and histochemical methods have been developed for quantitating p29 and relating its amount to receptors in human breast tumours. With both methods, highly significant (P less than 0.001) correlations with REC but not RP have been obtained. Both methods indicate that many REC-RP+ tumours contain p29. The histochemical method detects marked cellular heterogeneity in some tumours. The function of p29 is not known. It is an REC-related antigen that may be a previously undetected component of the oestradiol receptor machinery.

Cardiovascular consequences of beta-agonist tocolysis: an echocardiographic study

M-mode echocardiography was performed before and during intravenous beta-adrenergic agonist tocolysis in 13 patients with preterm labor. There was a significant increase in heart rate, fractional shortening, and calculated cardiac output. There was also a significant decrease in both end-systolic and end-diastolic left ventricular dimensions, which resolved in 24 to 36 hours. There were, however, no changes in left atrial dimensions. The data derived from this study suggest that the pulmonary edema occasionally complicating beta-adrenergic agonist tocolysis is not the result of systolic cardiac dysfunction.

Cutaneous silica granuloma

Cutaneous silica granuloma is a rare and fascinating cause of delayed scarring. Symptoms may arise many years after minor wounding if glass, sand, or other silica-containing particles have been embedded. Such granulomatous lesions are often nodular, indurated, and erythematous. They may respond to surgical excision or medical treatment, and in rare cases, they may spontaneously regress. We present one case in which three separate areas of cutaneous silica granulomas developed after a latent period of about 20 years and then involuted without intervention. The etiology and therapeutic options are discussed.

Postrhinoplasty "red nose": differential diagnosis and treatment by laser

Prior to anticipated nasal surgery, the nasal and facial skin should be examined for any vascular lesions. The skin type should be ascertained. A history of any prior nasal surgery, particularly on the nasal dorsum, should be noted. If rosacea is a clinical possibility, a trial of 1.5 to 2.0 gm q.d. of tetracycline for 6 to 8 weeks is warranted. If, after rhinoplasty, a diffuse "redness" on the nasal dorsum results and one can exclude other diagnoses, then argon laser therapy should be considered. A 3-mm punch biopsy should be obtained to see whether superficial ectatic vessels are present, a finding that would be indicative of a good result from laser therapy.

Electronic cell volume analysis of growth and rejection of EL-4 ascites tumor cells

The in vivo growth of EL-4 ascites tumor cells in peritoneal cavities of syngeneic (C57BL/6) and allogeneic (DBA/2) mice was monitored by electronic volume analysis. In the growth of EL-4 cells in the C57BL/6 mice, daily decrease in electronic modal cell volume and labeling indices was observed. After day 7, the rejection of EL-4 cells in DBA/2 mice was indicated by increase in the percentage of small cytotoxic lymphocytes and decrease in the labeling indices of tumor cells.

The effectiveness of post-detoxication referrals: effects on later detoxication admissions, drunkenness and criminality

This study concerned the effectiveness of post-detoxication referrals to a variety of treatment facilities. The purpose was to discover (i) the proportion of men accepting referrals who actually arrived, (ii) the differences in outcome for patients attending an out-patient clinic, a halfway house, and a long-stay farm, (iii) the differences in outcomes for patients treated in one of the above facilities compared with those for similar patients not receiving treatment. In all, 114 male detoxication admissions were included. However, only 60% arrived, even when firm referrals were made. Those arriving and not arriving did not differ in social or demographic characteristics, nor did those who were referred to the various treatment facilities. However, the referral group had more detoxication admissions in the post-detoxication period. There were no post-treatment overall differences between all treated and untreated patients in detoxication admissions, arrests for drunkenness or criminal convictions. Refusals were more often successes than the treated or untreated groups but this was due to their better prognosis at intake. In general, the data provide little cause for optimism about the value of post-detoxication referrals.

A comparison of recidivism rates for alcoholic detox residents referred to hospitals, halway houses, and outpatient facilities

Recidivism rates were studied for alcoholics referred to treatment facilities from a detoxication center. The aims were to examine (1) the proportions of clients who arrived, (2) whether similar clients were referred to different facilities, and (3) whether different facilities had different recovery rates. Only a minority improved in terms of recidivism. There were no differences for those referred to halfway houses, hospitals, and nonresidential programs. Those who arrived for treatment or completed it did not have higher improvement rates than those who did not.