A Study of Neuropathy in HIV Infection

A prospective study of possible aetiological factors for neuropathyassociated with HIV infection was performed in 80 patients and28 homosexual controls. At entry to the study twelve patients(15 per cent) had evidence of a generalized neuropathy not dueto any other cause and a further three patients developed symptomaticneuropathy during a mean (SD) follow-up of 20 (7.5) months.All but two of these neuropathies were of the distal symmetricalsensory type. Electrophysiology was consistent with an axonalpathology and nerve biopsy confirmed this as the major pathologicalchange. Warming threshold was the diagnostic test most frequentlyabnormal, sometimes in the absence of other electrophysiologicalabnormalities. No association was seen with opportunistic infection(cytomegalovirus, herpes simplex, Pneumocystis pneumonia, toxoplasmosis,Cryptococcus infection or tuberculosis). HIV proviral DNA couldnot be detected in paraffin sections of peripheral nerve insix patients with neuropathy. The presence of the neuropathydid not show significant correlation with depression of thenumber of CD4⁺T cells in the blood, impaired T cell functiontests, or IgG, IgM, or IgA levels. Immune complexes containingC1q,but not those containing IgG, IgM, IgA or C3c, were significantlymore common among neuropathic patients (     

The N-domain of the biliary glycoprotein (BGP) adhesion molecule mediates homotypic binding: domain interactions and epitope analysis of BGPc

The biliary glycoproteins (BGPs) represent a group of at least eight differentially spliced molecules belonging to the carcinoembryonic antigen (CEA) subgroup of the CEA family. These molecules are recognized by the CD66 monoclonal antibodies (MoAbs) and function as homotypic and heterotypic adhesion molecules. The extracellular region of the BGPc splice variant comprises an N-terminal IgV-like domain and three IgC2-set domains (A1, B1, and A2). Using soluble recombinant BGP domain variants, we demonstrate in this report that the N-terminal domain mediates homotypic adhesion. Furthermore, this adhesion is both temperature- and cation-dependent. The soluble domain variants of BGP are ideal molecules for epitope mapping. Using these constructs, we have mapped 11 MoAbs that react with the CEA family to different domains of BGPc and have shown that the CD66 MoAbs, YTH71.3.2 and CLBgran 10 (M38), recognize epitopes in the N-terminal domain.     

Evidence that cholecystokinin-enhanced retention is mediated by changes in opioid activity in the amygdala

Mice, partially trained to avoid footshock in a T-maze, showed enhanced retention relative to vehicle-injected mice when treated peripherally with arecoline, D-amphetamine, cholecystokinin octapeptide (CCK-8), epinephrine or naloxone. Both intra-amygdaloid and intraventricular injections of beta-endorphin resulted in amnesia. D-amphetamine and arecoline blocked the amnestic effect of beta-endorphin administered into the amygdala but it required higher doses for CCK-8, epinephrine and naloxone to block the amnestic effect of beta-endorphin. The effects of CCK-8, epinephrine and naloxone showed a differential ability to block amnesia induced by beta-endorphin intraventricularly with epinephrine and naloxone preventing amnesia but CCK-8 not improving retention. This data suggests that the memory enhancement produced by peripherally administered CCK-8 involves the amygdala and that both CCK-8 and epinephrine interact with opioid amnestic mechanisms within the amygdala to alter memory processing.     

The impact of curriculum-based suicide prevention programs for teenagers

The impact of three school-based suicide prevention programs was assessed by comparing attitudes and knowledge of 758 9th and 10th graders with those of 680 control pupils, matched on age, ethnicity, and socioeconomic status at the school level, who did not receive the programs. Evaluations were conducted before exposure to the programs and again 1 month later. A large majority of students knew and subscribed to some of the more important program goals before exposure to the program. There was little evidence of program impact among the minority that did not. Most students were interested by the programs, and positive reactions were more common among female and minority students.     

20α-Hydroxysteroid dehydrogenase expression in hemopoietic cell cultures and its relationship to interleukin 3

Expression of 20α-hydroxysteroid dehydrogenase (20α-SDH) has been investigated in long-term bone marrow cultures derived from normal and nude mice in the presence of horse serum and hydrocortisone. 20α -SDH expression rises markedly in the adherent cells derived from normal bone marrow. Early (1-5 days) lipid profiles are similar to those seen in T cells, but at later times (6-14 days) stromal-type lipid patterns dominate. Similar culture of fetal liver and nu/nu bone marrow cells shows rises in 20α -SDH expression, in situations where T cells are notably absent. The expression of 20α-SDH is not associated with detectable endogenous production of “interleukin 3” activity, and although addition of “IL 3” to bone marrow cultures increases the levels of 20α -SDH, this is associated with granulopoiesis rather than lymphoid development.     

Retention in outpatient drug free treatment clinics

This study examined time in treatment and the percentage of clients who quit or were expelled from drug treatment clinics as dependent measures in a general model including socioecological aspects of the clinic neighborhood environment, the clinic structure (attributes, e.g., size, and services and staffing), and the client composition of the clinic (sociodemographic and deviance). In this study the clinic was the unit of analysis.The data were analyzed by means of path analysis, for (1) drug free outpatient, nonopiate orientation (DFO-N) and (2) drug free outpatient, opiate orientation (DFO-O). There were 204 DFO-N and 130 DFO-O clinics.The path analytic model proved to be useful for the explanation of clinic retention outcomes. The socioecological variables predicted the types of clients who entered treatment. These in turn along with clinic attributes were significant predictors of clinic retention. Clinic attributes also predicted clinic services and staffing. The results suggested that both clinic variables and client composition variables are important predictors of clinic retention.     

Complications of surgically treated supracondylar fractures of the femur

Surgical treatment of supracondylar fractures of the femur has become commonplace. A variety of surgical implants are available. In carefully chosen patients treated with appropriate surgical technique, early motion and good knee function can be obtained with open reduction and internal fixation. However, the morbidity (and mortality) are substantial following complications of open reduction and internal fixation of supracondylar fractures of the femur. We present a series of 30 consecutive patients referred to Rancho Los Amigos Medical Center for complications following open reduction and internal fixation of supracondylar femur fractures. Three patients with septic pseudarthrosis underwent above-knee amputations. Two of these three patients died of systemic sepsis. Fourteen additional patients were treated for nonunions, with 13 patients achieving union at an average time of 36.5 months from the date of injury. Six patients underwent quadricepsplasties for residual knee stiffness. Only 16 patients were returned to their preinjury ambulatory status.     

Effects of dibutyryl adenosine 3',5'-cyclic monophosphate on erythropoietin production in human renal carcinoma cell cultures

A human renal carcinoma from a patient with erythrocytosis, serially transplanted into athymic nude mice, was grown in primary monolayer cell cultures. After reaching confluency, the cultured cells formed multicellular hemicysts (domes), which became more abundant as the cultures approached saturation density. Erythropoietin (Ep) production by this renal carcinoma in culture was only slightly increased at the time of semiconfluency but showed a marked increase after the cultures reached confluency, in parallel with dome formation. Dibutyryl adenosine 3',5'-cyclic monophosphate significantly (P less than .01) stimulated Ep production and dome formation in the semiconfluent and confluent cultures of the renal carcinoma.     

肝脏肿瘤的腹腔镜超声检查和活检术:310例经验

目的探讨腹腔镜超声肝脏检查及在其引导下肝脏肿瘤穿刺活检术的价值. 方法 10 mm 7.5 MHz线性超声探头检查肝脏.18G穿刺针进行穿刺.在腹腔镜和超声波共同引导下,穿刺针经皮刺入肿瘤组织.穿刺时,穿刺针要与超声波的平面平行. 结果 310例发现肝脏原发或转移性肿瘤1 080个.穿刺无一例假阴性,无出血性并发症及其他脏器损伤.310例随访6年,穿刺点无肿瘤种植. 结论腹腔镜超声波检查能较准确对肝脏进行全面评估,在其引导下细针穿刺活检术可行.     

Demarcation of myocardial ischemia: magnetic susceptibility effect of contrast medium in MR imaging

Dysprosium diethylenetriamine-pentaacetic acid-bis (methylamide) (DTPA-BMA), a new nonionic contrast medium for magnetic resonance (MR) imaging, produces signal loss on T2-weighted images because of induced magnetic field gradients. The potential of this agent to delineate myocardial ischemia was investigated in 10 rats with acute (30 minutes) occlusion of the left coronary artery. T2-weighted MR images were acquired before and for 1 hour after intravenous administration of 1 mmol/kg of Dy-DTPA-BMA. Before administration of the contrast medium, signal intensity (SI) in the ischemic region was significantly greater than that in the normal myocardium; however, the borders of the ischemic region were not consistently distinct. The contrast medium caused marked decrease in SI of normal myocardium (18% +/- 3% of the control value), only slight decrease in the jeopardized region (76% +/- 6% of the control value), and no discernible effects on heart rate or blood pressure. Substantial contrast between normal and ischemic myocardium persisted for 1 hour. Moderate signal loss was observed in skeletal muscle. Dy-DTPA-BMA has the potential to demarcate the myocardial area in jeopardy as a region of high signal intensity because it erases signal preferentially in the normal myocardium.