Extracellular fluid of the kidney preserved by the Collins technique.

Hilar drainage fluid of dog kidneys was analyzed as an approximation to renal extracellular fluid after preservation by flushing with chilled high K-low Na solution (Collins C4) followed by ice-cold storage for 24 and 48 hr in a bath of flushing medium. Compared with the medium, Na and Cl were increased to 30 mM/liter and K decreased slightly to 93 mM/liter. Glucose decreased, whereas lactate, lactic dehydrogenase, and creatine phosphokinase increased by significant amounts in both the drainage fluid and bath. The inulin space of the undrained kidney average 37% of wet weight. Calculated intracellular Na and Cl concentrations averaged 50 and 37 mM/kg cell water while K remained within normal limits. A significant fraction of red blood cells retained during initial flushing entered the effluent during storage. Bath and effluent composition of a human cadaver kidney approximated those of a dog.     

Development of a delayed-type hypersensitivity granuloma model in the mouse for the study of chronic immune-mediated inflammatory disease

A cutaneous model of delayed-type hypersensitivity granuloma (DTH GRA) was developed, using methylated bovine serum albumin (mBSA) which could be easily quantified and represented chronic cellular immune-mediated inflammation characteristic of rheumatoid arthritis (RA). Quantitative kinetics showed maximal DTH GRA wet tissue weights at d. 5 post-induction, diminishing between d. 15–22; DTH GRA dry tissue weights peaked between d. 8–22. Histological evaluation revealed early extensive fibrin deposition, edema, mixed PMN/mononuclear leucocyte infiltration and angiogenesis (d. 2–5), followed by increased macrophage recruitment, lymphocyte infiltration, angiogenesis and vasculitis (d. 10–15). Fibrin resorption and replacement by fibrous tissue resulted in resolution by d. 35. It is suggested that the DTH GRA reaction represents a relevant model for probing pathogenic mechanisms and potential therapeutics for RA.     

Results and policy implications of the resource-based relative-value study

The resource-based relative-value scale (RBRVS) is a measure of relative levels of resource input expended when physicians produce services and procedures. It is a function of the physician's work input, the opportunity cost of specialty training, and the relative practice costs for each specialty. This paper presents resource-based relative values (RBRVs) for selected procedures of four major specialties--family practice, internal medicine, general surgery, and thoracic and cardiovascular surgery. We compare RBRVs with current charges and find several general patterns. Invasive procedures are typically compensated at more than double the rate of evaluation-and-management services, when both consume the same resource inputs. Imaging and laboratory procedures fall between invasive and evaluation-and-management services. We analyze the financial implications of the RBRVS by developing a simple model and simulating the effects of an RBRVS-based fee schedule on physicians' revenues in various specialties. We use Medicare data to perform the simulation under the "budget-neutral" assumption. Results show that an RBRVS-based fee schedule affects specialties differently. The average family practitioner could receive 60 percent more revenue from Medicare, whereas the average ophthalmologist could lose 40 percent of current revenues. The effects on other specialties fall between these two.     

Cytogenetic studies in permissive and abortive infections by adenovirus type 12

Chromosome re-arrangements have been found in human cells infected in vitro with adenovirus type 12. Dicentric and ring chromosomes and chromatid re-arrangements were induced in cells infected during transition from GI to S phase. In non-permissive hybrid cells the development of monoclonal stem lines, associated with the persistence of the viral genome, has been demonstrated. Persistence of the virus in these cells results in continued induction of the uncoiler region of human chromosome E17. The association of viral nucleic acid with host-cell chromosomes has been confirmed by the in situ hybridization method.     

The XXXXY Sex Chromosome Abnormality

The most common sex chromosome complex in sex chromatin-positive males with Klinefelter's syndrome is XXY. When the complex is XXYY or XXXY, the clinical findings do not seem to differ materially from those seen in XXY subjects, although more patients with these intersexual chromosome complements need to be studied to establish possible phenotypical expressions of the chromosomal variants.

Two male children with an XXXXY sex chromosome abnormality are described. The data obtained from the study of these cases and five others described in the literature suggest that the XXXXY patient is likely to have congenital defects not usually seen in the common form of the Klinefelter syndrome. These include a triad of (1) skeletal anomalies (including radioulnar synostosis), (2) hypogenitalism (hypoplasia of penis and scrotum, incomplete descent of testes and defective prepubertal development of seminiferous tubules), and (3) greater risk of severe mental deficiency.

That the conclusions are based on data from a small number of patients is emphasized, together with the need for a cytogenetic survey of a large control or unselected population.