'Grown-up' survivors of congenital heart disease: who knows? Who cares?

'Grown-up' congenital cardiac patients are an increasing medical community, not at present being properly cared for in any country. Information on over 2000 patients aged 15-65 years with congenital heart disease who have been treated in the National Heart Hospital provides the data for this report.     

A novel method for culturing sweat gland epithelia: comparison of normal and cystic fibrosis tissues.

A new method is described to produce epithelial sheets by direct explantation of human sweat glands onto matrigel-coated millipore filters. The method is applicable to whole glands, separated coils or ducts and to normal and CF tissues. Electrogenic transport studies show that epithelia develop sodium transporting capability, even when explants are derived from secretory coils.     

Effects of hypothermia on testicular ischemia

The ischemic effects of prolonged testicular torsion have been well documented; however, prevention or arrest of the damaging effects of prolonged ischemia has been incompletely studied. Two groups of Sprague-Dawley rats were subjected to varying lengths of bilateral testicular ischemia. Group I underwent normothermic ischemia for two, four, and six hours. Likewise, Group II underwent similar time periods of ischemia, however, after thirty minutes of normothermic ischemia the scrotum of each animal was placed into an ice bath maintained at 4C. Two weeks postoperatively, bilateral orchiectomy was performed. Histology of the testes of the two groups was compared. Neither group revealed significant destruction of the germinal epithelium after two hours of ischemia. Group I revealed only 25% preservation of the germinal epithelium at four hours and only 8% preservation at six hours of ischemia. In contrast, Group II which received ice showed 90% preservation of germinal epithelium at four hours and 85% preservation at six hours of ischemia. We conclude that external ice application significantly preserves seminiferous tubules at four and six hours of ischemic injury in the rat testicle.     

Head lice in Israeli children: parents' answers to an epidemiological questionnaire

BACKGROUND: The aim was to determine the influence of the socioeconomic status of the family and the hygienic practices in the home on the prevalence of head lice infestation in children. METHODS: The study was carried out by analyzing the answers to a standardized epidemiological questionnaire given to parents of school children aged 4-17 in Bet Shemesh, a medium-sized urban town 25 km from Jerusalem. RESULTS: Of 3,000 questionnaires distributed, 958 (31.9%) were completed and returned. The majority of the children (72.4%) had been previously infested with lice. Half of them had other family members, mainly brothers and sisters, who had been infested in the past with lice. In 97.5% of the families the mother was responsible for examining the children for lice, and for carrying out treatment when infestation was present. An association was found between presence of lice infestation and mother's education, age of child, and frequency of shampooing, combing, and examination for lice. There was no association between infestation rates and mother's country of origin, crowding in the home, and the sharing of combs, brushes, hats, scarves, towels, and clothes. CONCLUSIONS: There is evidence that the incidence of lice infestation depends on the hygienic practices in the home rather than on the socioeconomic status of the family or sharing of personal articles among family members.     

Utility of radioisotopic filtration markers in chronic renal insufficiency: simultaneous comparison of 125I-iothalamate, 169Yb-DTPA, 99mTc-DTPA, and inulin. The Modification of Diet in Renal Disease Study

Assessment of glomerular filtration rate (GFR) with inulin is cumbersome and time-consuming. Radioisotopic filtration markers have been studied as filtration markers because they can be used without continuous intravenous (IV) infusion and because analysis is relatively simple. Although the clearances of 99mTc-diethylenetriamine-pentaacetic acid (DTPA), 169Yb-DTPA, and 125I-iothalamate have each been compared with inulin, rarely has the comparability of radioisotopic filtration markers been directly evaluated in the same subject. To this purpose, we determined the renal clearance of inulin administered by continuous infusion and the above radioisotopic filtration markers administered as bolus injections, simultaneously in four subjects with normal renal function and 16 subjects with renal insufficiency. Subjects were studied twice in order to assess within-study and between-study variability. Unlabeled iothalamate was infused during the second half of each study to assess its effect on clearances. We found that renal clearance of 125I-iothalamate and 169Yb-DTPA significantly exceeded clearance of inulin in patients with renal insufficiency, but only by several mL.min-1.1.73m-2. Overestimation of inulin clearance by radioisotopic filtration markers was found in all normal subjects. No differences between markers were found in the coefficient of variation of clearances either between periods on a given study day (within-day variability) or between the two study days (between-day variability). The true test variability between days did not correlate with within-test variability. We conclude that the renal clearance of 99mTc-DTPA, 169Yb-DTPA, or 125I-iothalamate administered as a single IV or subcutaneous injection can be used to accurately measure GFR in subjects with renal insufficiency; use of the single injection technique may overestimate GFR in normal subjects.     

Altered serum immunoglobulin response to model intestinal antigens during dietary exposure to vomitoxin (deoxynivalenol)

The effect of dietary vomitoxin on the serum IgA and IgG responses to two model intestinal antigens, casein and cholera toxin (CT), were assessed in 4 experimental groups: (1) mice fed casein-based diet, (2) mice fed casein-based diet containing 25 ppm vomitoxin, (3) mice fed casein-based diet and immunized with CT, and (4) mice fed casein-based diet containing 25 ppm vomitoxin and immunized with CT. Unimmunized and CT-immunized mice that were fed vomitoxin exhibited increased levels of total serum IgA relative to matched control animals fed the standard diet. Relative concentrations of casein-specific IgA were greater in both unimmunized mice and CT-immunized mice fed standard diet with vomitoxin than in matched controls fed standard diet only. CT-specific serum IgA in CT-immunized mice was not affected by vomitoxin feeding, but relative levels of CT-specific IgA were higher in unimmunized mice fed vomitoxin than in unimmunized mice fed standard diet. Both casein- and CT-specific serum IgG were depressed in mice fed vomitoxin. Significant differences in total, casein-specific and CT-specific IgA within the intestinal contents were not observed between CT-immunized mice fed vomitoxin and those fed the control diet. The results suggest that vomitoxin altered regulation of the normal immunoglobulin response to intestinal antigens and that this was manifested in the systemic compartment.     

Reduction of embryonic intracellular pH: a potential mechanism of acetazolamide-induced limb malformations

The effects of acetazolamide on the developing rodent limb bud were postulated to result from a reduction of intracellular pH (pHi). Embryonic intracellular pH was calculated from transplacental distribution of the weak acid, 5,5'-dimethyloxazolidine-2,4-dione, in teratogenically sensitive (C57BL/6) and resistant (SWV) inbred mice. pHi was reduced by acetazolamide treatment in C57 embryos and limb buds but not in SWV samples. Acetazolamide teratogenesis can be exacerbated by coadministration of amiloride, presumably through inhibition of Na+/H+ exchange attributable to the latter agent. pHi reduction after such treatment was more profound than after acetazolamide alone, providing further support for the central hypothesis. pH was also reduced in other embryonic (embryo plasma) and extraembryonic compartments (exocoelomic fluid, amniotic fluid). pH changes in these compartments could also lead or contribute to abnormal development.     

Comparison of rat liver preservation with Eurocollins and a modified University of Wisconsin solution: transplantation and isolation of hepatocytes for culture

The efficiency of Eurocollins or modified University of Wisconsin (UW) solution (MUW) in preserving rat livers was compared. After cold storage with one of the solutions, the livers were transplanted or perfused by collagenase for isolation of hepatocytes. Five of the 6 rats receiving a graft preserved with MUW versus none of the 6 rat receiving a graft preserved with Eurocollins solution survived 24 h or more. A significantly greater number of hepatocytes were isolated from livers preserved with MUW than from livers preserved with Eurocollins solution. This suggests a better reperfusion of MUW-preserved livers by collagenase resulting from less endothelial injury. LDH release by cultured hepatocytes, ketone body production and stimulation by glucagon were not significantly different between the two groups. These results confirm the superiority of MUW solution over Eurocollins in preserving liver grafts. They suggest that the advantage of MUW solution results from better protection of vascular endothelium rather than of hepatocytes.