Paternal age at childbirth and eating disorders in offspring

BACKGROUND

Advanced paternal age at childbirth is associated with psychiatric disorders in offspring, including schizophrenia, bipolar disorder and autism. However, few studies have investigated paternal age's relationship with eating disorders in offspring. In a large, population-based cohort, we examined the association between paternal age and offspring eating disorders, and whether that association remains after adjustment for potential confounders (e.g. parental education level) that may be related to late/early selection into fatherhood and to eating disorder incidence.

METHOD

Data for 2 276 809 individuals born in Sweden 1979-2001 were extracted from Swedish population and healthcare registers. The authors used Cox proportional hazards models to examine the effect of paternal age on the first incidence of healthcare-recorded anorexia nervosa (AN) and all eating disorders (AED) occurring 1987-2009. Models were adjusted for sex, birth order, maternal age at childbirth, and maternal and paternal covariates including country of birth, highest education level, and lifetime psychiatric and criminal history.

RESULTS

Even after adjustment for covariates including maternal age, advanced paternal age was associated with increased risk, and younger paternal age with decreased risk, of AN and AED. For example, the fully adjusted hazard ratio for the 45+ years (v. the 25-29 years) paternal age category was 1.32 [95% confidence interval (CI) 1.14-1.53] for AN and 1.26 (95% CI 1.13-1.40) for AED.

CONCLUSIONS

In this large, population-based cohort, paternal age at childbirth was positively associated with eating disorders in offspring, even after adjustment for potential confounders. Future research should further explore potential explanations for the association, including de novo mutations in the paternal germline.

A genome-wide association study of anorexia nervosa

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Sex differences and developmental stability in genetic and environmental influences on psychoactive substance consumption from early adolescence to young adulthood

BACKGROUND

Genetic and environmental factors are important in the etiology of substance use. However, little is known about the stability of these factors across development. We aimed to answer three crucial questions about this etiology that have never been addressed in a single study: (1) Is there a general vulnerability to substance consumption from early adolescence to young adulthood? (2) If so, do the genetic and environmental influences on this vulnerability change across development? (3) Do these developmental processes differ in males and females?

METHOD

Subjects included 1480 twin pairs from the Swedish Twin Study of Child and Adolescent Development who have been followed since 1994. Prospective, self-reported regular smoking, alcohol intoxication and illicit drug use were assessed at ages 13-14, 16-17 and 19-20 years. Structural modeling was performed with the program Mx.

RESULTS

An underlying common factor accounted for the association between smoking, alcohol and illicit drug consumption for the three age groups. Common genetic and shared environmental effects showed substantial continuity. In general, as participants aged, the influence of the shared environment decreased, and genetic effects became more substance specific in their effect.

CONCLUSIONS

The current report answers three important questions in the etiology of substance use. The genetic and environmental risk for substance consumption is partly mediated through a common factor and is partly substance specific. Developmentally, evidence was strongest for stability of common genetic effects, with less evidence for genetic innovation. These processes seem to be the same in males and females.

Bacterial activity associated with the decomposition of woody substrates in a stream sediment

Ground bark and heartwood from Alnus rubra and Pseudotsuga menziesii were added to a muddy sediment from a small Oregon stream and incubated in situ. Carbon dioxide and methane production rates were increased by all amendments, the biggest increase being shown with A. rubra wood. Except for sediment amended with A. rubra wood, nitrogen fixation rates from all treatments (including the control) were approximately 0.1 nmol/g per h throughout the 6-month study period. Contrary to expectations, neither bark had a noticeable adverse effect on microbial activity, but the A. rubra wood promoted nitrogen fixation. These results help to explain the faster rate of decomposition of A. rubra wood in water compared with that of P. menziesii described in the literature. The uptake kinetics of glucose (V(max)) did not follow the same pattern as gas evolution.

Prospective randomized comparison of 50%/50% versus 65%/65% tilt biphasic waveform on defibrillation in humans

It is unknown if there is a single optimal biphasic waveform for defibrillation. Biphasic waveform tilt may be an important determinant of defibrillation efficacy. The purpose of this study was to compare acute defibrillation success with a three-electrode configuration in humans using 50%/50% versus 65%/65% tilt truncated exponential, biphasic waveforms delivered through a 110-microF capacitor. Acute DFTs for biphasic waveforms with 50%/50% versus 65%/65% tilt were measured in random order in 60 patients using a binary search method. The electrode configuration consisted of a RV coil as the cathode, and a SVC coil plus a pectoral active can emulator (CAN) as the anode. The waveforms were derived from an external voltage source with 110-microF capacitance, and the leading edge voltage of phase 2 was equal to the trailing edge voltage of phase 1. Stored energy DFT (9.2 +/- 5.7 [50%/50%] vs 10.8 +/- 6.4 [65%/65%] J, P = 0.007), current DFT (10.9 +/- 4.0 [50%/50%] vs 12.0 +/- 4.4 [65%/65%] A, P = 0.002) and voltage DFT (391 +/- 118 [50%/50%] vs 424 +/- 128 [65%/65%] V, P = 0.004) were significantly lower for the 50%/50% tilt waveform versus the 65%/65% tilt waveform using this three-electrode configuration and a 110-microF capacitor. For an RV(-)/SVC plus CAN(+) electrode configuration and a 110-microF capacitor, a 50%/50% tilt biphasic waveform results in a 15% reduction in energy DFT, 9% reduction in current DFT, and 8% reduction in voltage DFT versus a 65%/65% tilt biphasic waveform.

The brain response to 2-deoxy glucose is blocked by a glial drug

Two brain regions - the basomedial hypothalamus and area postrema (AP) - react to changes in circulating glucose levels by altering feeding behavior and the secretion of pituitary and non-pituitary hormones. The precise identity of cells responding to glucose in these regions is uncertain. The recent detection of high-capacity glucose transporter proteins in astrocytes in these areas has suggested that astrocytes may play a role in glucose sensing by the brain. To test this hypothesis, rats were injected with either saline or methionine sulfoximine (MS), a compound that produces alterations in carbohydrate and glutamate metabolism in astrocytes. Eighteen hours later, rats were injected with either saline or 2-deoxy glucose (2-DG) and brain sections were stained to demonstrate 2-DG-activated neurons immunoreactive for Fos protein. MS-treated rats showed a 70% reduction in numbers of Fos+ neurons in the AP region (p<0.05). Also, specialized, Gomori+ astrocytes were particularly abundant in both glucose sensitive regions and showed a distribution identical to that reported for high-capacity glucose transporter proteins. These data suggest that specialized astrocytes influence the glucose-sensing function of the brain.

Evidence for polar cytoplasm/nuage in rat oocytes

In many organisms oocytes contain dark-staining material, termed nuage, that is concentrated at one pole of the oocyte cytoplasm and that influences the further development of the oocyte after fertilization. In mammalian oocytes, ultrastructural studies have detected small patches of nuage-like material, but thus far no nuage-rich zone of polar cytoplasm has been reported. Here, we report that when large sections of rat ovary embedded in methacrylate resin are stained with toluidine blue and surveyed, many oocytes contain a narrow, sharply defined, basophilic zone of polar cytoplasm that appears analogous to the polar cytoplasm of Xenopus and other non-mammalian species. This basophilic polar cytoplasm was common in multilaminar follicles and was not visible in smaller, primordial follicles. In one out of five oocytes stimulated with hCG to complete the first meiotic division, a relatively faint region of cortical basophilia was detectable. Further studies will be needed to ascertain if this nuage-like material has an influence upon the development of oocytes similar to that seen in non-mammalian species.

Duodenal motor responses in preterm infants fed formula with varying concentrations and rates of infusion

Feeding intolerance is frequently reflected in preterm infants by delayed gastric emptying. Gastric emptying is delayed by the physical characteristics of ingested nutrient as well as the rate of feeding. Because gastric emptying is dependent upon duodenal function, the present studies were undertaken to assess duodenal motor responses to feeding of differing nutrient content and rate of feeding. Using a Latin square design we recorded duodenal motor responses in 14 preterm infants given four test feedings in random order over 18 h. Three were given as a 120-min infusion containing no nutrient, a 10 cal/oz formula, and a 20 cal/oz formula. The fourth test feeding consisted of a 20 cal/oz formula given as a bolus over 15 min. Although caloric density was altered, osmotic load and nutrient proportions of the formulas were not. Motor responses were recorded using a low compliance continuous perfusion manometric system. When infants were fed "water" and half-strength formula as a slow infusion, they demonstrated little or no duodenal motor response to feeding. When these infants were fed full-strength formula as a slow infusion, they displayed a brisk increase in motor activity (p < 0.05), but profound motor quiescence when fed the same volume by bolus over 15 min (p < 0.05). Of the four test feedings, only full-strength formula given as a slow infusion triggered adult-like duodenal motor responses to feeding. We speculate that feedings of full-strength formula given slowly by infusion will improve feeding tolerance.

A prospective, randomized evaluation of a nonthoracotomy implantable cardioverter defibrillator lead system. Endotak/PRX Investigator Group

Nonthoractomy lead systems for ICDs have been developed that obviate the need for a thoracotomy and reduce the morbidity and mortality associated with implantation. However, an adequate DFT cannot be achieved in some patients using transvenous electrodes alone. Thus, a new subcutaneous "array" electrode was designed and tested in a prospective, randomized trial that compared the DFT obtained using monophasic shock waveforms with a single transvenous lead alone that has two defibrillating electrodes, the transvenous lead linked to a subcutaneous/submuscular patch electrode, and the transvenous lead linked to the investigational array electrode. There were 267 patients randomized to one of the three nonthoracotomy ICD lead systems. All had DFTs that met the implantation criterion of < or = 25 J. The resultant study population was 82% male and 18% female, mean age of 63 +/- 11 years. The indication for ICD implantation was monomorphic VT in 70%, VF in 19%, monomorphic VT/VF in 6%, and polymorphic VT in 4% of the patients, respectively. The mean LVEF was 0.33 +/- 0.13. The mean DFT obtained with the transvenous lead alone was 17.5 +/- 4.9 J as compared to 16.9 +/- 5.5 J with the lead linked to a patch electrode (P = NS), and 14.9 +/- 5.6 with the lead linked to the array electrode (array versus lead alone, P = 0.0001; array versus lead/patch, P = 0.007). The results of this investigation suggest that the subcutaneous array may be superior to the standard patch as a subcutaneous electrode to lower the DFT and increase the margin of safety for successful nonthoracotomy defibrillation.

Posterior left thoracic cardiac sympathectomy by surgical division of the sympathetic chain: an alternative approach to treatment of the long QT syndrome

Although high thoracic left sympathectomy via an anterior surgical approach is a highly efficacious treatment for refractory ventricular arrhythmias in patients with the long QT syndrome, the degree of sympathetic denervation has been variable, success of the operation is influenced by anatomical differences between patients, and Horner's syndrome may result. We hypothesized that interruption of sympathetic input to the heart could be accomplished using a posterior thoracic approach to this variable and often complex anatomy by division of the sympathetic chain rather than by direct destruction of the stellate and superior thoracic ganglia with the more conventional anterior, supraclavicular approach. In addition, the posterior approach should decrease the risk of Horner's syndrome by avoiding the ocular sympathetic efferent nerves. This posterior approach is described in five patients with the long QT syndrome and recurrent ventricular arrhythmias. After a mean follow-up of 18 +/- 12 months, all are alive without Horner's syndrome.

PR/RR interval ratio during rapid atrial pacing: a simple method for confirming the presence of slow AV nodal pathway conduction

INTRODUCTION

Although the AV conduction curve in patients with AV nodal reentrant tachycardia (AVNRT) is usually discontinuous, many patients with this arrhythmia do not demonstrate criteria for dual AV nodal pathways. During rapid atrial pacing, the PR interval often exceeds the pacing cycle length when there is anterograde conduction over the slow pathway and AVNRT is induced. The purpose of this prospective study was to determine the diagnostic value of the ratio of the PR interval to the RR interval during rapid atrial pacing as an indicator of anterograde slow pathway conduction in patients undergoing electrophysiologic testing.

METHODS AND RESULTS

The PR and RR intervals were measured during rapid atrial pacing at the maximum rate with consistent 1:1 AV conduction in four study groups: (1) patients with inducible AV nodal reentry and the classical criterion for dual AV nodal pathways during atrial extrastimulus testing (AVNRT Group 1); (2) patients with inducible AV nodal reentry without dual AV nodal pathways (AVNRT Group 2); (3) control subjects < or = 60 years of age without inducible AV nodal reentry; and (4) control subjects > 60 years of age without inducible AV nodal reentry. For both groups of patients with inducible AV nodal reentry, AV conduction was assessed before and after radiofrequency ablation of the slow AV nodal pathway. Before slow pathway ablation, the PR/RR ratio exceeded 1.0 in 12 of 13 AVNRT Group 1 patients (mean 1.27 +/- 0.21) and 16 of 17 AVNRT Group 2 patients (mean 1.18 +/- 0.15, P = NS Group 1 vs Group 2). After slow pathway ablation, the maximum PR/RR ratio was < 1.0 in all AVNRT patients (Group 1 = 0.59 +/- 0.08, P < 0.00001 vs before ablation; Group 2 = 0.67 +/- 0.11; P < 0.00001 vs before ablation). Among both groups of control subjects, the PR/RR ratio was > 1.0 in only 3 of 27 patients with no relation to patient age.

CONCLUSION

The ratio of the PR interval to the RR interval during rapid atrial pacing at the maximum rate with consistent 1:1 AV conduction provides a simple and clinically useful method for determining the presence of slow AV nodal pathway conduction. This finding may be particularly useful in patients with inducible AV nodal reentry without dual AV nodal physiology on atrial extrastimulus testing.

Immunoreactivity for brain-fatty acid binding protein in gomori-positive astrocytes

Gomori-positive (GP) astrocytes are a subset of brain astrocytes with highly stained cytoplasmic granules that arise from the degradation of mitochondria. The GP granules of these astrocytes are most prominent in the arcuate nucleus of the hypothalamus, but can also be detected in the olfactory bulbs, hippocampus, habenula, and other selected brain regions. The cause and functional effects of this mitochondrial pathology in these glia are not yet known with certainty. In other tissues, mitochondrial dysfunction is associated with elevations in cytoplasmic lipids and lipid-binding proteins, due to impaired mitochondrial oxidation of lipids. To see if GP astrocytic mitochondrial pathology is also associated with an elevation in lipid binding proteins, rat brain sections were stained for brain fatty acid binding protein (B-FABP), using immunocytochemistry. Astrocytes immunoreactive for B-FABP were much more abundant in brain regions enriched in GP astrocytes than in other brain regions. Semi-thin sections revealed that astrocytic B-FABP immunoreactivity was often, but not always, associated with GP cytoplasmic granules. These data suggest that GP astrocytes have an unusual lipid metabolism, which may relate to degenerative processes occurring in the selected brain regions that contain GP astrocytes.

Predictors of recurrent atrioventricular nodal reentry after selective slow pathway ablation

Although radiofrequency catheter ablation of the slow atrioventricular (AV) nodal pathway is highly effective for the management of AV nodal reentrant tachycardia (AVNRT), this arrhythmia may recur in some patients after an ablation procedure that initially renders AVNRT noninducible. A retrospective study examined the factors that are associated with the recurrence of AVNRT after selective radiofrequency catheter ablation of the slow pathway. Patients were included in the study if they had initially inducible, typical slow-fast AVNRT that was noninducible at the end of the ablation session. Selective ablation of the slow pathway was performed using radiofrequency energy applied along the tricuspid annulus near the coronary sinus ostium. AVNRT recurred after initially successful slow pathway ablation in 10 of 136 patients (7.4%) over a mean follow-up period of 20.1 +/- 5.0 months; the time to recurrence ranged from 1 to 411 days. Despite the absence of inducible AVNRT, dual anterograde AV nodal conduction properties persisted after slow pathway ablation in 10 patients. AVNRT recurred in 4 of 10 patients who had evidence of residual slow pathway conduction compared with only 6 of 126 who had no residual slow pathway conduction (p = 0.003). All patients with persistent slow pathway conduction and recurrent AVNRT also had residual AV nodal echo beats. AVNRT recurred in 3 of 6 patients without accelerated junctional tachycardia during radiofrequency application compared with only 7 of 109 with accelerated junctional tachycardia (p = 0.003). Thus, AVNRT infrequently recurs after successful selective radiofrequency ablation of the slow pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Paraplegia and traumatic rupture of the aorta: a disease process or surgical complication?

Surgical repair of traumatic rupture of the aorta results in an excellent survival rate especially among the young, although paraplegia continues to be a serious postoperative complication. The authors present nine cases admitted to Stoke Mandeville Hospital, England, including detailed post-mortem findings on one of the cases. Although it was difficult to be certain of the patients' general and neurological status prior to surgery, as it was not well documented in the patients' case notes, it was evident that systemic hypotension and poor distal aortic perfusion were responsible for the disabling complication. A review of the initial medical management of these patients and the surgical techniques employed in repairing such injuries is urgently needed.

Muscle regeneration following segmental necrosis in tenotomized muscle fibers

The aim of this study was to determine how the new myotendinous junctions were re-established at the proximal and distal ends of the soleus muscle after tenotomy. Both proximal and distal tendons of the soleus muscle in mature female rats were severed. The animals were killed and the soleus muscles were removed and prepared for light and electron microscopic examination 1, 3, 5, 7, 14, 21, 28, and 42 days after the operation. It was found that segmental fiber destruction followed by removal by macrophages occurred at the ends of the soleus muscle fibers. This resulted in the liberation and myogenic activation of satellite cells. By 3 days after tenotomy the fusion of myoblasts to form myotubes could be seen. The myotubes developed within the original basal lamina and reattached to the surviving non-necrotic segments and grew in both length and width so that by 6 weeks postoperation, normal myotendinous junctions had been reformed. This study is the first to show that re-establishment of the myotendinous junction following tenotomy is accomplished by regeneration of the necrotic ends of the tenotomized fibers.

Association of iron-containing astrocytes with dopaminergic neurons of the arcuate nucleus

Specialized astrocytes, identified by cytoplasmic granules that are electron-dense and vividly stained by toluidine blue due to the presence in the granules of SH molecules and molecules of iron, have long been known to be present within the arcuate nucleus of the hypothalamus. Their function, however, is obscure. To determine whether or not these specialized astrocytes are in contact with dopaminergic neurons, rat brain sections were stained to detect tyrosine hydroxylase (TH) immunoreactive neurons by immunocytochemistry and were examined by both light and electron microscopy. Iron-rich astrocytes were located in the same general portion of the arcuate nucleus as were TH+ neurons, and most appeared closely associated with TH+ structures (somas, dendrites, and fibers) at the light-microscopic level. At the ultrastructural level, close contact between TH + neurons and processes of iron-rich glia was confirmed. This unique anatomical association suggests a functional relationship between the two cell types that may be related to unusual histochemical features of both cell types and/or to the location of these cells in an area with a highly permeable blood-brain barrier.

Elevated serum IgE, eosinophilia, and lung function in rubber workers

We previously reported an outbreak of acute respiratory illness associated with eosinophilia in a group of rubber workers who performed a thermoinjection process in which synthetic rubber was heated and then injected onto metal molds. This study was conducted to determine if persistent respiratory health effects were associated with this work area and to explore the possible allergic etiology of this syndrome. A survey was performed 1 mo after a major improvement in area ventilation and consisted of baseline, cross-shift, and cross-week spirometry; diffusing capacity; serum immunoglobulin E (IgE), total eosinophil count; and skin patch testing. Baseline lung function, cross-shift, and cross-week spirometry were not significantly worse in the exposed group as compared to the control group. However, either eosinophilia (greater than 450/mm3) or elevated serum IgE (greater than 470 ng/ml) were present in 44% of exposed workers vs. 11% of the control group (p = .003). Nine months later, neither eosinophilia nor elevated IgE were associated with employment in this work area. We conclude that employment in the thermoinjection process was associated with eosinophilia and elevated IgE, which suggests sensitization to one of the components of the rubber, although no effect on pulmonary function could be demonstrated.

Fungemia caused by an amphotericin B-resistant isolate of Sporothrix schenckii. Successful treatment with itraconazole

A 58-year-old, alcoholic, diabetic man presented with multiple, ulcerated skin lesions and polymicrobial septicemia. Sporothrix schenckii was recovered from blood cultures and was resistant to amphotericin B by in vitro testing. Amphotericin B therapy failed, but the patient responded dramatically to itraconazole therapy, only to relapse 3 months after therapy was stopped. Reinstitution of itraconazole therapy has produced another dramatic response. This report is noteworthy for three reasons. First, to our knowledge, it represents only the second reported instance of fungemia with S schenckii that responded to medical therapy. Second, it illustrates that in vitro antifungal susceptibility tests may predict clinical infection response to drug therapy. Third, it suggests that itraconazole has significant promise in treating systemic sporotrichosis.

Fate of bacteria ingested by larvae of the freshwater mayfly,Ephemera danica

The fate of bacteria in the food of a common freshwater invertebrate has been studied both in controlled laboratory experiments and in a stream sediment. The animal chosen was the larva of the burrowing mayfly,Ephemera danica. It ingested all available bacteria nonselectively. More bacteria were found associated with the hindgut than with the mesenteron despite continuous plug flow of food through the alimentary canal. Species of bacteria were affected in different ways.Aeromonas hydrophila andCitrobacter freundii were both digested, the former selectively.Flavobacterium sp. and other unidentified species appeared to attach to the hindgut wall. Digestion of bacteria was not due to a sudden change in pH.

Adaptation of skeletal muscle to immobilization in a shortened position

This study determined the morphological changes and adaptations that occur following immobilization of rat soleus and gastrocnemius muscles when the ankle joint is placed in complete plantar flexion for 2, 5, 7, 14, 21, and 28 days by means of plaster casts. Previous studies of such shortened muscles have shown that the number of sarcomeres in series is reduced, but how the sarcomeres are reduced has not been determined. We observed that the fibers in the mid-belly region of the muscles demonstrated a progressive degenerative process over the first few weeks. Myofibrils across the entire width of the affected fibers underwent dissolution. However, by 4 weeks new myofibrils were being formed, and sarcomere lengths appeared normal. Portions of the fibers near the tendon underwent segmental necrosis. These findings are similar to the response of the soleus and gastrocnemius muscles to tenotomy and are clinically relevant to orthopedic procedures that maintain muscles in shortened conditions for prolonged periods.

Eosinophilia, respiratory symptoms and pulmonary infiltrates in rubber workers

This report describes a spectrum of respiratory illnesses associated with eosinophilia which occurred in a group of workers exposed to fumes from a synthetic rubber-based curing operation. Respiratory syndromes induced by this exposure included an acute sensitizing illness with dyspnea and wheezing in some workers and pulmonary infiltrates with eosinophilia in others. Another worker developed chronic obstruction of the airways with recurrent bronchitic illnesses. Mild to marked peripheral eosinophilia, up to 3,000/cu mm, was usually present in the symptomatic workers and in 11 of 30 asymptomatic workers. These cases illustrate the diversity of respiratory illnesses which may result from a common workplace exposure and reinforce the importance of considering occupational exposures in the differential diagnosis of peripheral eosinophilia.

Degeneration and alteration of axons and intrafusal muscle fibers in spindles following tenotomy

The effect of tenotomy (cutting of distal and proximal tendons) on the spindles in soleus muscle of adult rats was examined by light and electron microscopy in tissue obtained 1, 2, 3, 4, 5, 6, 7, and 14 days after surgery. Degenerative changes in the spindles progressed with time; also, the degree of alteration observed in a spindle varied with its position in the muscle, i.e., the earliest and most extensive changes occurred in spindles situated near the tendons. The disorganization and breakdown of myofibrils in the intrafusal muscle fibers were observed 3 days after tenotomy and continued with longer periods after surgery. The progression of morphological changes included alteration in fiber outline and the external lamina of the intrafusal muscle fibers and changes in the extracellular environment within the spindle capsule. The intrafusal muscle fibers of some spindles were shortened, apparently due to the loss of their polar ends, and degenerated axons which apparently supplied the intrafusal muscle fibers were also observed. Completely necrotic intrafusal fibers were absent. A possible relationship between the observed morphologic alterations and an adjustment of the spindle to muscle shortening is discussed.

Hysterical paraplegia

Between 1944 and 1984 20 patients were admitted to a spinal injuries centre with a diagnosis of traumatic paraplegia. They subsequently walked out and the diagnosis was revised to hysterical paraplegia. A further 23 patients with incomplete traumatic injuries, who also walked from the centre, have been compared with them as controls. The features that enabled a diagnosis of hysterical paraplegia to be arrived at were: They were predominantly paraplegic, There was a high incidence of previous psychiatric illness and employment in the Health Service or allied professions, Many were actively seeking compensation. The physical findings were a disproportionate motor paralysis, non anatomical sensory loss, the presence of downgoing plantar responses, normal tone and reflexes. They made a rapid total recovery. In contrast, the control traumatic cases showed an incomplete recovery and a persistent residual neurological deficit. Investigations apart from plain radiographs of the spinal column were not warranted, and the diagnosis should be possible on clinical grounds alone.

Calcium-activated protease activity in tenotomized muscle

The purpose of this study was to investigate the possible role of calcium-activated neutral protease in the disorganization and dissolution of the myofibrils of the rat soleus that occurs following tenotomy. Rats were killed 3, 5, 7, 14, 21, and 42 days after tenotomy of the soleus, and the muscles were removed and assayed for calcium-activated protease activity. Maximal protease activity occurred 1 week after tenotomy, at the time when myofibril organization is completely disrupted. Activity was still high 2 and 3 weeks after the operation, but returned to normal levels by 6 weeks, when muscle histology had returned to normal. The time course of the calcium-activated protease activity corresponded closely to the time course of the morphological changes. Thus, calcium-activated neutral protease may play a major role in myofibrillar proteolysis following tenotomy and in making the myofibril susceptible to proteolytic attack by other, less specific proteases.

Relationship between microbial activity of stream sediments, determined by three different methods, and abiotic variables

Microbial activity of stream sediments has been determined by three distinct methods: phosphatase levels, maximum uptake velocity of radiolabeled glucose, and carbon dioxide production rates. These methods have been applied to different types of sediment (mud, sand, gravel) from the same stream and to 5 samples from two different streams for comparison. Temperature, discharge, and 8 other abiotic variables for each sample were also determined. The 3 activity methods correlated closely with each other and were measured with a similar precision. Phosphatase activity could be predicted for all sites from bulk density. The largest proportion of the variance associated with carbon dioxide production was explained by variations in percent of organic matter, but the relationship did not hold for all streams. Maximum uptake velocity, compared with the other 2 activity measurements, was poorly explained by any of the abiotic variables.

Peripheral eosinophilia and respiratory symptoms in rubber injection press operators: a case-control study

To evaluate a suspected association between an outbreak of acute respiratory illness and eosinophilia and employment as a rubber worker, we performed a retrospective review of medical records of rubber workers employed from September 1983 to July 1984 in a plant housing a thermoinjection process. Twenty-five workers met the case definition of a respiratory illness requiring a physician visit. The predominant respiratory illness was acute in onset with cough, chest tightness, and dyspnea. Peripheral eosinophilia, up to 40% of white blood cells in a peripheral smear, was seen in 10 of 18 (56%) cases. Twenty-one of 25 white males with respiratory symptoms were employed in the thermoinjection process (odds ratio = 22, p less than .001). Smoking and employment in this process contributed independently to an increased risk of being a case as determined by a logistic regression analysis. Return to the plant building caused recurrence of symptoms in most cases, and these workers have been transferred or left the company. We conclude that a strong previously unrecognized association exists between employment in this neoprene rubber thermoinjection process and the development of an acute respiratory illness.

The development of central cores in both fiber types in tenotomized muscle

Using the histochemical reaction for myosin adenosine triphosphatase (ATPase), a study of the rat soleus muscle following tenotomy was undertaken. It was demonstrated that both type 2A and 2C fibers undergo degenerative changes following tenotomy. All previous studies have stated that only type 1 fibers were affected and developed central core lesions and that type 2 fibers were somehow protected from the degenerative process. The results of this experiment illustrate that central core lesions will develop in all three fiber types (types 1, 2A, and 2C) of the soleus following tenotomy.

Atropine toxicity in acute cervical spinal injury

A patient with a C.3/C.4 fracture dislocation resulting in an incomplete tetraplegia was treated with Cimetidine 400 mg bd to prevent gastrointestinal bleeding and 0.6 mg of atropine 6 hourly. He developed symptoms of atropine poisoning in the form of hallucinations, confusion and dilated pupils when the total dosage of atropine was 2.8 mg. This is far below the toxic levels normally considered necessary to produce atropine poisoning. The patient recovered. In view of the fact that this combination of drugs may be used in spinal units to prevent gastrointestinal bleeding and bradycardia, this experience is reported.

Traumatic cerebral flaccid paraplegia

Two cases of paraplegia caused by head injuries sustained in recent military conflicts are presented. The underlying pathological disturbances could be related to the CT scan appearances and are discussed in the light of previously reported series. Both cases were remarkable for an early and prolonged paraplegia which was flaccid, rather than spastic, and for the sensory impairment produced.

Factors affecting the bacterial colonization of various surfaces in a river

The colonization rates of substrates, differing in their surface charge and asperity, have been determined in a temperate river. Glass, which has a high surface charge, was colonized by the natural bacterial population just as fast as polystyrene with a low surface charge. However, roughening the surface of either substrate greatly increased the rate of bacterial colonization. On the roughened surfaces bacteria did not selectively colonize cavities or grooves and current velocity was not an important factor. It is suggested that different sections of the naturally occurring bacterial population are the initial colonizers of different types of surface.

Ultrastructural and biochemical changes in rat soleus muscle following tenotomy

This study was designed to correlate changes in the rate-limiting enzymes of glycogen synthesis (glycogen synthase) and glycogen breakdown (glycogen phosphorylase) with the ultrastructural changes which occur in the soleus muscle following tenotomy. Soleus muscles were removed at 1, 2, 3, 7, 14, 21, and 63 days after tenotomy and were prepared for electron microscopy or frozen for enzyme analysis. In the first 7 days posttenotomy, soleus muscle fibers underwent a series of degenerative changes, while both synthase and phosphorylase activities decreased. Over the next 8 weeks the histological appearance of the soleus muscle eventually returned to normal while synthase and phosphorylase activities increased. We suggest that recovery from tenotomy involves an increase in the energy demands of the muscle, resulting in the increased activity of the key rate-limiting enzymes of muscle glycogen metabolism from the drastically reduced levels observed in the period before recovery begins.

Changes in sarcomere length following tenotomy in the rat

The medial belly of the gastrocnemius and the extensor digitorum longus muscles of rats were tenotomized. One day following tenotomy, the mean sarcomere length of the fast medial gastrocnemius was 1.8 microns, a value comparable to that of tenotomized slow soleus. The mean sarcomere length of the tenotomized extensor digitorum longus, however, was 2.0 microns, a figure which differed significantly from the values obtained for both the soleus and the gastrocnemius. Histological preparations showed the presence of central core degeneration in slow fatigue-resistant fibers of the tenotomized gastrocnemius comparable to that seen in the soleus. No changes were found in the fibers of the tenotomized extensor digitorum longus. The fact that central core lesions were produced in the fibers of soleus and medial gastrocnemius but not in the extensor digitorum longus may be related to the lesser reduction in sarcomere length following tenotomy of the latter muscle.

Recovery from central core degeneration of the tenotomized rat soleus muscle

The soleus muscle of the rat undergoes degenerative changes after tenotomy. The effects are maximal one week postoperatively, after which follows a period of recovery. Muscle histology eventually returns to normal six week after tenotomy. Recovery is effected by means of peripheral myofibril splitting and de novo synthesis of myofibrils within the central portion of the fiber.

Laboratory growth rates of six species of freshwater Gymnamoebia

Laboratory growth rates of six species of Gymnamoebia, isolated from English chalk streams and cultured on bacteria, have been determined at four different temperatures. Generation times ranged from 4.46 to 33.3 h. A linear relationship between log₁₀ specific growth rate and the reciprocal of the absolute temperature was demonstrated for four species. A significant regression of log₁₀ generation time on log₁₀ cell volume was obtained for data on amoebae in combination with data on ciliates taken from the literature. This regression may be used to predict the growth rates of other species of amoebae and ciliates of known cell volume.

Changes in length of sarcomeres following tenotomy of the rat soleus muscle

Tenotomy of the proximal and distal tendons of the soleus muscle of female Wistar rats was performed and sarcomeric length and muscle fascicle length measured. On the first postoperative day muscle bellies were found shortened and their sarcomeric length considerably reduced. Four weeks following tenotomy, although the muscle bellies remained shortened, sarcomeric length was comparable with that of control muscles. Measurement of muscle fascicle lengths at this time showed that those of experimental muscles were nearly 50% less than those of control muscles. It was concluded from these experiments that a reduction of the number of sarcomeres in series had occurred, thus compensating for the reduced length of the muscle belly.

Estimation of bacterial production in fresh waters by the simultaneous measurement of [35S]sulphate and d-[3H]glucose uptake in the dark

Sulphate uptake in the dark by phytoplankton constitutes a severe limitation to the determination of bacterial heterotrophic production from sulphate-uptake rates. Consequently a modification to the 35S-method has been developed involving size fractionation to separate the algae from the bacteria. Both the whole water sample and the algae-free filtrate are incubated in the dark with trace quantities of [3H]glucose, whereas the filtrate alone is incubated with 35SO4. The experimental determined ratio (whole sample glucose assimilation: filtrate glucose assimilation) is used to correct the measured sulphate uptake (filtrate) and yields an estimate of bacterial sulphate uptake in the whole sample. A potential filtration artefact has been demonstrated in the 35SO4 uptake methodology. Excision of the outer edge of the membrane filter and counting of the inner wetted circle alone eliminated this problem and significantly improved the analytical performance of the method: coefficient of variation approximately 5%, detection limit approximately 2 ng S l-1 h-1. The modified [35SO4]-[3H]-glucose method was applied to samples from an English chalk stream: bacterial sulphate uptake was higher during the spring diatom maximum (10.6 ng S l-1h-1) than 3 weeks later when detritus dominated the seston (4.9 ng S l-1h-1). We estimate the corresponding rates of formation of particulate (bacterial) carbon to be 0.53 and 0.24 microgram C l-1h-1 respectively.

Autoradiographic study of the permeability characteristics of the small intestine

This autoradiographic study demonstrates the distribution of a range of small solutes and macromolecules in the mucosa of the guinea-pig small intestine after intracardiac injection. The substances investigated were: 14C-urea, 3H-mannose, 3H-inulin, and 125I polyvinylpyrrolidone (PVP). Small bowel biopsies were taken at intervals from one to 60 minutes after injection and the tissues processed for autoradiography. Light microscopic examination of the autoradiographs showed that the compartmental distribution depended on the molecular size of the substances being studied. Urea and mannose, as small solutes, were uniformly distributed throughout the intravascular, extravascular, and epithelial compartments. Inulin was evenly distributed in the vessel lumen and extravascular space but there was a considerable drop in concentration in the epithelium. PVP exhibited the most marked gradients, the concentration being greatest in the vascular lumina, lower in the extravascular space, least in the epithelium. Thus there appear to be two barriers to macromolecular passage which are freely permeable to small solutes: the capillary wall and the epithelium. At a light microscopical level it is not possible to observe whether the limiting membrane of each of these barriers is the cell plasmalemmal membrane or the basement membrane. The selectivity of the epithelial barrier is greater than that of the capillary barrier.

Role of the accompanying anion in the effect of calcium salts on potassium uptake by excised barley roots

The effect of addition of Ca salts on accumulation of K from 5 mN KCl or K(2)SO(4) solutions was found to depend on whether Ca was added as Cl or SO(4) salt. Chloride as well as K uptake was increased when Ca and Cl concentrations in culture solutions were increased. Pre-treatment of roots with CaCl(2) stimulated subsequent K uptake from K(2)SO(4) solutions as compared to pre-treatment with distilled water but pre-treatment with CaSO(4) did not. The results indicate that addition of Ca salts to KCl or K(2)SO(4) solutions increased anion uptake and the effect of the addition of the Ca salts on K uptake was in part the result of increased anion uptake and not entirely a direct effect of Ca.In contrast, accumulation of Na and K from solutions containing these ions as SO(4) or Cl salts was changed from preferential uptake of Na to preferential uptake of K by addition of either CaCl(2) or CaSO(4). Thus, while Ca salts may influence K accumulation partly as a result of effects on anion uptake, the selectivity for K uptake depends on the presence of Ca and is influenced little by the accompanying anion.