UNUSUAL FUNGAL INFECTIONS ASSOCIATED WITH IMMUNOLOGIC HYPOREACTIVITY

Two patients had unusual fungal infections, considered to be contaminants, which suggested immunologic hyporeactivity. One patient with a Fusarium infection had an associated occult malignancy. The other patient had an initial localized, then disseminated Curvularia infection. Both patients, following analysis of subpopulations of lymphocytes, showed evidence of relative T and B cell defects.     

Rubin's "Puerperal Change" Reconsidered

A preliminary study was conducted to examine if 1) healthy new mothers exhibit Rubin's "Taking-in" and "Taking-hold' behaviors and attitudes and 2) if these behaviors and attitudes change during the course of hospitalization. Twenty subjects were surveyed on each postpartal hospital day at a large, west coast urban hospital. While the women exhibited some of the behavior and attitude changes, the findings do not support the specific time aspects described by Rubin. Implications for nursing practice, education, and research are discussed.     

A possible role for mono(ADP-ribosyl)transferase in the signalling pathway mediating neutrophil chemotaxis

1 Mono(ADP-ribosyl)transferase activity has been identified on the external surface of human polymorphonuclear neutrophil leucocytes (PMNs). The enzyme is released from the plasma membrane by phosphoinositide-specific phospholipase C, suggesting a glycosylphosphatidylinositol (GPI) linkage of the enzyme to the plasma membrane. Partial sequence of cDNA encoding the enzyme suggests that it is identical to the GPI-linked mono(ADP-ribosyl)transferase identified previously on human skeletal muscle.
2 A panel of inhibitors of mono(ADP-ribosyl)transferase (including vitamins K₁ and K₃, novobiocin and nicotinamide) showed a rank order of inhibitory potency similar to that described for other mono(ADP-ribosyl)transferases. Furthermore, the mono(ADP-ribosyl)ation of agmatine was inhibited also by diethylamino(benzylidineamino)guanidine (DEA-BAG), another substrate of the enzyme related structurally to arginine.
3 There was a close linear correlation between the I C ₅₀ values for inhibition of mono(ADP-ribosyl)ation of agmatine by DEA-BAG or the enzyme inhibitors and their I C ₅₀ values for inhibition of receptor-dependent polymerization of cytoskeletal actin and chemotaxis.
4 These results suggest a role for mono(ADP-ribosyl)transferase in the transduction pathway involved in receptor-dependent re-alignment of the cytoskeleton during neutrophil chemotaxis.     

The use of esmolol to attenuate the haemodynamic response when extubating patients following cardiac surgery -- a double-blind controlled study

We have assessed the cardiovascular changes associated withemergence from anaesthesia, reversal of neuromuscular blockadeand extubation in a group of 14 patients immediately after coronaryartery bypass graft surgery had been completed. Patients wererandomly allocated to receive either esmolol 500µg. kg^–1over 1 min followed by 100 µg . kg^–1. min^–1or placebo starting prior to reversal. Significant hypertensionand tachycardia occurred in the placebo group, whilst thesechanges were prevented by the administration of esmolol.     

The ultrastructure of benign and malignant fibrous histiocytomas

Five benign histiocytomas of varying pattern and three malignant fibrous histiocytomas have been studied ultrastructurally. An essentially biphasic pattern of histiocytes and fibroblasts was present. In addition fibrohistiocytes, myofibroblasts and undifferentiated cells were present in some of the tumours. The histogenesis of this group of tumours is discussed. The value of electron microscopy in establishing the diagnosis in difficult cases is emphasized, but it is not considered useful in distinguishing benign from malignant cases.     

Primary signet ring cell carcinoma of the breast

Three examples of primary signet ring cell carcinoma of the breast are described. This form of breast carcinoma deserves recognition as an entity because its prognosis may differ from colloid carcinoma of the breast and because of potential difficulty in distinguishing it from metastatic carcinoma.     

Implications for Mother and Infant, Challenge for the Nurse

A review of postterm pregnancy and the postmature newborn is presented. It includes definitions, problems encountered, guidelines for identification of high risk, and the psychological impact on the pregnant woman. A final section summarizes the special challenge postterm pregnancies present to the nurse.     

Phenotypes and genotypes in cystinuria

Quantitative data are presented on the cystine, lysine and arginine excretion in patients with cystine stone formation and in their relatives in twenty-five families.
It is suggested that two distinct abnormal phenotypes can be differentiated. Phenotype 1 is characterized by a greatly increased excretion of cystine, lysine, arginine and ornithine. Because of the high cystine concentration in the urine cystine stone formation is fairly frequent. Phenotype 2 is characterized by a moderately increased cystine and lysine excretion, whilst the arginine and ornithine excretion is normal or only slightly raised. In this phenotype stone formation occurs only very rarely.
The families fall into two groups with regard to the occurrence of phenotype 2. In one group of families phenotype 2 is not found. In these families the segregation of phenotype 1 is consistent with the hypothesis that it represents the homozygote for a rare recessive gene. This type has been called 'recessive cystinuria'. In the other group of families phenotype 2 is frequently found. Most of the propositi are of phenotype 1. The distribution of the two abnormal phenotypes in such families is consistent with the hypothesis that phenotype 1 represents the homozygote, and phenotype 2 the heterozygote, of a rare abnormal gene. Two families have propositi of phenotype 2 who, in this instance, happen to have formed stones. These families contain no individuals of phenotype 1. Phenotype 2 again segregates in a manner which suggests that it represents the heterozygote of an abnormal gene. In all families in which phenotype 2 is found the condition has been called 'incompletely recessive cystinuria'.