Problem Drinkers in Medical Wards: consumption patterns and disabilities in newly identified male cases

One hundred and sixty-one male medical inpatients were identified as problem drinkers according to criteria previously defined. This paper describes the pattern of their drinking and the associated medical and psychosocial problems. Over half had been admitted with an illness not typically related to alcohol and a similar proportion reported levels of consumption which have previously been considered safe. Classical symptoms of dependence were uncommon but specific enquiry revealed a broad range of social problems related to alcohol. Recognition of this profile is necessary if problem drinkers are to be identified at an early stage and to benefit from counselling.     

Long-term Survival of VDD Pacing

All patients with VDD systems implanted at a tertiary pacing center were identified from a computer database and data collected on pacing indications, follow-up duration, rate response, reasons for programming changes, and implant P wave amplitudes. Results: 366 implants were identified for which complete data were available for 335 leads implanted in 316 patients. The mean follow-up period was 24.1 months, and age at implant was 73.5 ± 11.8 years. During follow-up, 19 patients died (6%) and 62 (19.6%) were followed elsewhere. Indications for pacing were complete heart block, 56.6%; intermittent AV block, 21.8%; postablation complete heart block, 5.4%; 2:1 AV block, 13%; and others, 3.2%. Two groups: no mode change (NMC, n = 280) and mode change (MC, n = 36) were identified. Reasons for reprogramming in the MC group were as follows: atrial sensing, 11; AF/atrial flutter, 18; chronotropic incompetence, 3; and others 4. Significantly more MC patients had rate response programmed ON (44.4% vs 22.1%, P < 0.05). No significant differences between the two groups were found in other variables, including male gender (55.5% vs 54.6%), length of follow-up (27.1 ± 17.8 vs 23.8 ± 20.6 months), age at last follow-up (72 ± 12.3 vs 75.9 ± 11.9years), and P wave amplitude (1.7 ± 0.9 vs 1.8 ± 0.9mV). Conclusion: Reprogramming of VDD systems is infrequent. When necessary, it is usually prompted by atrial arrhythmias or failure of atrial sensing. When adequate atrial chronotropy has been verified, VDD is an acceptable alternative to DDD pacing and survives well over the long term.     

The Radiology of Bronchial Atresia Radiographic,CT and Bronchography Correlation

We examined two patients with bronchial atresia. Both cases involved the left upper lobe: the anterior and the lingular segments respectively. Mucoid impaction and hyperinflation seen with radiography or computed tomography (CT) are typical findings. Bronchography in conjunction with bronchoscopy is an efficient means to confirm the atretic segment as well as the patency of the proximal bronchi respectively.     

Attendance allowance at age 16: time for review

At the age of 16 years, young disabled people receiving attendance allowance are required to reapply for the benefit to establish their entitlement. As a consequence a substantial minority lose the benefit altogether or have it reduced. If this happens they can ask for a review of the decision and about two-thirds of those who do so are successful in having the allowance restored. This paper is concerned with the reassessment and review of attendance allowance at 16 years and is based on a study of a sample of young disabled people who had recently experienced the process. It concludes that inconsistency in the assessment process represents an unnecessary risk to the entitlement of recipients.     

Circadian Aqueous Flow Mediated by β-arrestin Induced Homologous Desensitization

It was hypothesized that homologous desensitization regulates signal transduction from the beta-adrenergic receptor in the ocular ciliary epithelium to affect the circadian rhythm of aqueous humor secretion. β-arrestin-1 was cloned from the rabbit ciliary epithelium, and the full length cDNA used as a probe for Northern blot analysis to examine the diurnal expression of β-arrestin mRNA. Protein expression of β-arrestin-1 at intervals during the circadian cycle of aqueous secretion showed a decrease in β-arrestin expression when maximal activation of the β-adrenergic receptor is known to increase secretion. Diurnal expression of β-arrestin suggests that homologous desensitization can regulate the circadian rhythm of aqueous flow.     

Synthesis and characterization of defensin NP-1

Defensins are a group of small, cationic, antimicrobial proteins found in the cytoplasmic granules of neutrophils and macrophages of a variety of mammalian species. One such defensin, NP-1, isolated from rabbit neutrophils, has been shown to consist of 33 amino acids rich in arginine and cysteine residues (6). We have synthesized NP-1 on an Applied Biosystems Model 431A peptide synthesizer using FastMoc? chemistry involving HBtu [2-1H-benzotriazol-1-y1)-1,1,3,3-tetramethyluronium hexafluorophosphate] activation for coupling amino acids. The linear peptide was folded by air oxidation to the biologically active form containing three disulfide bonds and purified by reverse phase chromatography. The amino acid sequence of the synthetic peptide was confirmed by Edman degradation. Molecular weight determination by plasma desorption mass spectroscopy (PDMS) gave a value of 3898.6, in agreement with the expected molecular weight of 3898. The biological activity of the synthetic peptide, as measured by its antifungal activity against several pathogenic fungi, was indistinguishable from that of the natural NP-1. Also, the CD spectrum was equivalent to that of natural NP-1, indicating conformational identity of the two species.     

Rapamycin‐mediated suppression of renal cyst expansion in del34 Pkd1−/− mutant mouse embryos: An investigation of the feasibility of renal cyst prevention in the foetus

Aim: Polycystic kidney disease (PKD) in humans involves kidney cyst expansion beginning in utero. Recessive PKD can result in end‐stage renal disease (ESRD) within the first decade, whereas autosomal dominant PKD (ADPKD), caused by mutations in the PKD1 or PKD2 gene, typically leads to ESRD by the fifth decade of life. Inhibition of mTOR signalling was recently found to halt cyst formation in adult ADPKD mice. In contrast, no studies have investigated potential treatments to prevent cyst formation in utero in recessive PKD. Given that homozygous Pkd1 mutant mice exhibit cyst formation in utero, we decided to investigate whether mTOR inhibition in utero ameliorates kidney cyst formation in foetal Pkd1 homozygous mutant mice. Methods: Pregnant Pkd1^+/? female mice (mated with Pkd1^+/? male mice) were treated with rapamycin from E14.5 to E17.5. Foetal kidneys were dissected, genotyped and evaluated by cyst size as well as expression of the developmental marker, Pax2. Results: Numerous cysts were present in Pkd1^?/? kidneys, which were twice the weight of wild‐type kidneys. Cyst size was reduced by a third in rapamycin‐treated Pkd1^?/? kidney sections and kidney mass was reduced to near wild‐type levels. However, total cyst number was not reduced compared with control embryos. Pax2 expression and kidney development were unaltered in rapamycin‐treated mice but some lethality was observed in Pkd1^?/? null embryos. Conclusion: Rapamycin treatment reduces cyst formation in Pkd1^?/? mutant mice; therefore, the prevention of kidney cyst expansion in utero by mTOR inhibition is feasible. However, selective rapamycin‐associated lethality limits its usefulness as a treatment in utero.