Isolation from the serum of cancer patients and molecular structure determination of a ketone derivative of D3 vitamin

In a previous article we have reported our finding of an unknown vitamin derivative in the serum of cancer patients and in rats transplanted by a malignant tumor. Analysis of this compound extracted from serum of cancer patients, was carried out by I.R., U.V., mass spectrography and nuclear magnetic resonance (N.M.R.) determination. This analysis led us to the conclusion that the compound was a ketone derivative of D3 vitamin: 1-ceto-24-methyl-25-hydroxycholecalciferol, provisionally designated D3C. Enzymatic pathways involved in the biosynthesis of this substance and its possible role in normal and pathological cell division are discussed.     

Severe hemorrhagic radiation proctitis advancing to gradual cessation with hyperbaric oxygen

Summary We report a case of a male patient suffering from a severe hemorrhagic radiation proctitis which gradually ceased with hyperbaric oxygen. We discuss the mechanisms of chronic radiation injury and the effect of the hyperbaric oxygen. This therapy is proposed as an alternative to surgical intervention for this abnormality.     

A comparative clinical study of the safety and efficacy of three toothbrushes.

This single (examiner) blind, randomized, 4-week study compared the safety and efficacy of a new electric toothbrush (experimental) regarding plaque removal and reducing gingivitis with two other brushes, an electric brush (control electric) and a manual toothbrush (control hand). Ninety-six subjects with 1) a minimum of 15 suitable teeth in acceptable occlusion; 2) a minimum gingivitis score of 0.9; and 3) a minimum plaque score of 1.8 were entered into the study. The subjects were randomly assigned to one of 3 groups: a control hand group (31 subjects), an experimental group (32 subjects), and a control electric group (33 subjects). Device use instructions were given according to the manufacturer's recommendations. Two examiners separately determined either gingival scores or plaque scores at baseline and 4 weeks. In regard to gingivitis, use of all 3 brushes for the study period showed statistically significant improvements in gingivitis scores (P values less than 0.01) within each of the 3 groups. Between group analyses of covariance showed that of the 3 groups, the control hand group improvement was better than both the experimental and the control electric groups (P less than 0.05). When interproximal gingivitis scores were analyzed separately, similar improvements were noted. Regarding effectiveness of plaque removal during a single brushing event at the initial and final visits, each of the 3 brushes was effective in reducing plaque for every tooth surface scored (P values less than 0.01). However, between group analyses of covariances showed that the experimental group was better than the other two (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Genome locations of temperature-sensitive mutants in glycoprotein gB of herpes simplex virus type 1

A plasmid containing a herpes simplex virus type 1 (HSV-1) insert from strain KOS, prototypic coordinates 0.345 to 0.368 (3.45 kilobases) was mutagenized in vitro, and potential mutations were introduced into intact viral DNA by cotransfection. Functions normally associated with the glycoprotein gB are in the 1-9 complementation group, and the above coordinates include those that specify the gB glycoprotein gene. Following cotransfection, individual plaques were screened for temperature sensitivity (ts) of viral growth. A total of seven ts mutants was obtained, of which four were spurious mutations due to alterations outside the cloned sequences, presumably mediated by some aspect of the Ca-precipitation-cotransfection method. The remaining three did not complement known mutants of the 1-9 complementation group. These three mutants, along with tsJ12 (P.A. Schaffer, G.M. Aron, N. Biswal, and M. Benyesh-Melnick, 1973, Virology 52, 57-71) and tsJ33 (C.-T. Chu, D.S. Parris, R.A.F. Dixon, F.E. Farber, and P.A. Schaffer, 1979, Virology 98, 168-181), were physically located by marker-rescue experiments to three different restriction fragments between 0.345 to 0.368 map units. Sodium dodecyl sulfate-gel electrophoresis was used to analyze the glycoproteins synthesized during continuous or pulse-chase labeling protocols. All five mutants were found to synthesize a precursor of gB but did not accumulate mature gB during a pulse, a chase, or continuous labeling at the nonpermissive temperature.     

Postoperative water and electrolyte changes in skeletal muscle: a clinical study with three different intravenous infusions

Twenty-seven patients admitted for cholecystectomy were matched for age and sex in three groups for different perioperative fluid therapies over a period of 3 days. Group I was given an acetated half-isotone "balanced" saline solution with the addition of 2.5% glucose, Group II an acetated Ringer solution and Group III an isotonic glucose solution. Percutaneous muscle biopsies were performed before and on the third day after surgery for the determination of water content and the concentration of sodium, potassium, magnesium and chloride in skeletal muscle. The cumulative balance of sodium and potassium was measured daily during the study. In all three groups a significant increase in the total muscle water content was demonstrated. The concentration of sodium and chloride in skeletal muscle increased significantly in Groups II and III, whereas the concentration of potassium decreased in all groups. The cumulative sodium balance was positive in Groups I and II; the potassium balance was negative in all groups. In conclusion, the patients given the balanced saline solution showed the least change in water content and electrolyte concentrations in skeletal muscle.     

Elevated neutrophil to lymphocyte ratio is associated with poor long-term survival and graft failure after lung transplantation

PurposeWe aimed to assess the prognostic value of Neutrophil to Lymphocyte Ratio (NLR) on long-term outcomes and graft dysfunction after lung transplantation.MethodsWe retrospectively reviewed all patients receiving a lung transplant at our institution from 2011 to 2014. The primary exposure was elevated NLR at the time of transplant, defined by NLR>4. The primary outcomes were graft failure and three-year all-cause mortality. Multivariate logistic regression and Kaplan-Meier survival analysis were used to analyze outcomes.Results95 patients were included. 40 patients (42%) had an elevated NLR. Elevated NLR was associated with graft failure (OR: 4.7 [1.2–18.8], p = 0.02), and three-year mortality (OR: 5.4 [1.3–23.2], p = 0.03) on multivariate logistic regression. Patients with elevated NLR demonstrated significantly lower survival on Kaplan-Meier analysis (50% versus 74%, p = 0.02). The c-statistic for our multivariate model was 0.91.ConclusionElevated neutrophil to lymphocyte ratio is associated with poor long-term survival and graft failure after lung transplantation.     

A process model of diagnostic reasoning in medicine

The paper presents a model-based approach to diagnostic reasoning in medicine. A process model is defined on the levels of static elements, dynamic elements and reasoning control. Static elements, facts, hypotheses and different types of disease knowledge, are identified and variations relevant for hypotheses generation are described. Dynamic elements correspond to actions, which in turn modify static elements, but are also controlled and started by the expressions of the static elements. Hypothesis generation starts with the assessment of a given set of facts. According to their priorities, facts are used for the construction of a diagnostic differential: new hypotheses are considered, existing hypothesis refined or excluded. The purpose of hypotheses generation is to establish a complete diagnostic differential with disjunctive explanations which explain a given set of facts. The presented model could serve as a basis for an implementation in a model-based and process-oriented decision-support system.     

Alkaline phosphatase and peptidase levels in invertebrate cartilage

Summary Cartilage is encountered in the skeletons of many advanced invertebrates, yet it never calcifies or is replaced by bone. In an attempt to account for the absence of bone in invertebrates, we tested a hypothesis proposing that absence or inadequate quantities of several enzymes associated with vertebrate osteogenesis may underlie the failure of the invertebrates to evolve bone. The enzymes examined were alkaline phosphatase, alanyl -naphthylamidase, and neutral protease. Their activities were measured in the gill cartilage of the Atlantic horseshoe crab, Limulus polyphemus, and the odontophore cartilage of the marine whelk, Busycon canaliculatum. Animals were collected from the Cape Cod area. Samples of cartilage of Limulus perichondrium, various nonskeletal tissues, and neonatal rat calvaria, the latter as a reference standard, were homogenized in 0.1 M phosphate buffer (pH 7.1) and analyzed for protein content and the above-mentioned enzyme activities. Alkaline phosphatase specific activity was readily detected in most tissues except the invertebrate cartilage specimens in which it was present only at near-trace levels. Naphthylamidase and protease activities were present in all tissues. In a single experiment, higher phosphatase values were recorded for Limulus cartilage retaining perichondrium, but in a subsequent trial assaying cartilage retaining perichondrium, denuded cartilage, and isolated perichondrium separately, it was demonstrated that phosphatase activity resided primarily within the perichondrium. Exposure of thick cryostat sections to p-nitrophenyl phosphate confirmed the suspicion that alkaline phosphatase activity was present principally in the perichondrium. In view of the strong association between alkaline phosphatase and vertebrate cartilage mineralization it is proposed that extremely low levels of this enzyme may contribute to the failure of invertebrate cartilage to be replaced by bone.