Mortality in a sample of convicted drinking drivers

Mortality rates for 639 drinking drivers were calculated. The sample consisted of all individuals convicted of a second offence in two Ontario cities (Oshawa and North Bay) between 1973 and late 1978. There were 53 deaths (51 males, 2 females) in the sample prior to the end of 1986. Among males, significant excess total mortality was observed (Standardized Mortality Ratio = 1.7); similar trends were observed among females. Age-related excess mortality and excess mortality by cause were strikingly similar to mortality patterns observed among alcoholics.     

Dialysis-related amyloidosis: Pathogenetic aspects and therapeutic considerations

Summary: Beyond renal transplantation and the provision of symptomatic relief, approaches to treat dialysis-related amyloidosis (DRA), an important long-term complication in patients on regular dialysis, must be based on the knowledge of the underlying pathogenetic process. Retention of beta₂-microglobulin (β₂m) is the prerequisite; biochemical alterations of β₃₂m increasing its amyloidogenicity, and local predisposing tissue factors together with age appear to be relevant. A growing body of evidence points toward the importance of pro-inflammatory effects of dialysis (blood-membrane interactions, pyrogen-related priming of cytokine producing mononuclear cells) in the development of DRA. Advanced glycation endproduct formation (AGE-β₂m) may represent a central element in the pathogenesis of DRA. For non-transplant therapy of DRA, the main goals must be the optimization of β₂m removal (high-flux haemodialysis, haemofiltration, especially pre-dilution haemofiltration) and reduction of pro-inflammatory effects of dialysis (use of non-complement activating biocompatible membranes, pyrogen free dialysate). At least patients at high risk for DRA should be treated according to these guidelines.     

Neurohormonal effects of early treatment with enalapril after acute myocardial infarction and the impact on left ventricular remodelling

Plasma neurohormones were sequentially analysed in 98 patientswith acute myocardial infarction randomized to treatment withenalapril or placebo for 4–6 months. Plasma angiotensinconverting enzyme activity was rapidly suppressed by enalapril,but unaffected by placebo (P = 0.0001). No significant differenceswere found in the plasma levels of angiotensin II, aldosterone,atrial natriuretic peptide, noradrenaline, adrenaline or dopaminebetween the two treatment groups. Among patients with infarctsize above median, plasma angiotensin II increased during head-uptilt at one month in the placebo group, but not in the enalaprilgroup. Left ventricular end-diastolic volume (LVEDV) and leftventricular endsystolic volume (LVESV) were evaluated by echocardiographyin 28 patients (placebo 15, enalapril 13) and changes in leftventricular volumes between baseline and 4–6 months werecalculated. Only in the placebo group was a positive correlationfound between plasma levels of noradrenaline at day 5–7and the subsequent increase in LVEDV (r = 0.78, P = 0.005) andLVESV (r = 0.75, P = 0.008). The same trend was found for angiotensinII, adrenaline and dopamine levels at days 5–7 and thesubsequent increase in left ventricular volumes. In the placebogroup a negative correlation was found between plasma aldosteroneat days 5–7 and the subsequent increase in left ventricularejection fraction (r = –0.77, P = 0.006) during the studyperiod. Although circulating neurohormones were not significantlyinfluenced by enalapril treatment, it is concluded that enalaprilmay influence the relationship found between sustained neurohormonalactivation and left ventricular remodelling after acute myocardialinfarction.     

Purification and characterization of a 65-kilodalton diisopropylfluorophosphate-binding protein in the outer membrane of Fusobacterium nucleatum Fev1

Abstract— A 65-kilodalton protein was identified in the outer membrane of Fusobacterium nucleatum Fevl by SDS-PAGE. The relative amount of the protein varied during growth, being greatest in stationary phase. The protein was radio-labeled by [¹²⁵I]-lactoperoxidase treatment of live cells and was only partially cxtractable with 2% sodium dodecylsulfatc (SDS) at room temperature, and therefore assumed to be both exposed to the cell surface and peptidoglycan associated. In intact cells the protein bound diisopropylfluorophosphate (DFP), indicating that it may be a serine protease. DFP-binding activity depended apparently on proper localization of the proteins in the membrane. Several methods were tried in attempts to purify the 65-kilodalton protein; the method that gave best results was preparative SDS-polyacrylamide gel electrophoresis. The isoelectric point was determined to about pH 5. Amino acid composition analysis showed that the 65-kilodalton protein possesses an excess of hydrophilic over hydrophobic residues, polarity index 52%. The N -terminal end of the protein was apparently blocked.