HIV vaccine research continues despite setbacks

New agents for treating asthma and allergic disease are now under development. From Arris Pharmaceutical comes recombinant neutral endopeptidase (rNEP), ^* an agent that may prove effective as prophylaxis against symptomatic episodes in patients with moderate-to-severe asthma. A group of compounds known as tryptase inhibitors may also be of use in inflammatory diseases such as asthma, as preclinical studies have shown that they can prevent airway inflammation in sheep. In addition, Tanox Biosystems is developing therapies that target immunoglobulin E (IgE), which is a key mediator of atopic allergic disease. News of recent progress with these agents was presented at an IBC USA conference on Asthma [ Philadelphia, US; October 1995 ].     

The effects and after-effects of interferon alpha on human performance, mood and physiological functions

The effects of three doses of interferon alpha (IFNα, 1.5 Mu, 0.5 Mu and 0.1 Mu) on performance, mood and physiological function were examined in a double-blind placebo controlled trial. The subjects given an injection of 1.5 Mu showed symptoms which closely resembled those seen in influenza, although most of the symptoms had gone by the next day. All of the doses of IFN reduced subjective ratings of alertness, but again this effect was only apparent on the day of challenge. Subjects given the 1.5 Mu injection were slower on two of the performance tasks (a simple reaction time task and a pegboard task) both on the day of challenge and the following day. None of the other tasks in the battery was impaired by any of the doses of IFN, either on the day of challenge or the following day. These results suggest that IFNα has selective effects on performance, and it is possible that IFN-induced changes in CNS function provide a mechanism through which viral infections influence behaviour.     

Men''s disclosure of HIV test results to male primary sex partners.

We evaluated disclosure of human immunodeficiency virus (HIV) antibody status to a main sex partner and the impact on the relationship in men who have sex with men and who are enrolled in the Acquired Immunodeficiency Syndrome (AIDS) Community Demonstration Projects cohorts. Eighty-nine percent of both seronegative and seropositive men disclosed the results to their main sex partner. Seventy percent of the seronegative men and 82% of the seropositive men who did so reported that the relationship remained "as strong as ever" after 6 months. Most men who did not disclose their test results to their main partner reported being "single" after 6 months.     

Computed tomographic scan confirmation of paraprosthetic enteric fistula

Aortoenteric anastomotic fistulae and paraprosthetic graft infections are rare but devastating complications following aortic graft surgery. Although the incidence of these complications is reported to be less than 2%, the difficulty in diagnosis and management has led to high mortality rates and extensive morbidity. The majority of patients present with either groin infection or significant gastrointestinal tract bleeding. There is, however, a subset of patients with nonspecific clinical findings in whom routine studies are not diagnostic. Computed tomography was a useful adjunct to the diagnosis of retroperitoneal infection in these patients by demonstrating small collections of periaortic gas or "black dots." The presence of periaortic gas in each instance proved to be a specific sign of a paraprosthetic-enteric fistula, as opposed to a graft infection without intestinal communication.     

Surgical resection in the management of small cell carcinoma of the lung

In an attempt to define the role of initial surgical resection in patients with undifferentiated small cell carcinoma of the lung, we reviewed the experience of the Veterans Administration Surgical Oncology Group (VASOG). One hundred forty-eight patients with small cell carcinoma of the lung had undergone a potentially "curative" resection. This represented 4.7% of "curative" resections carried out in four major prospective adjuvant chemotherapy trials. In the early trials (101 patients), 16 patients (15.8%) died within the first 30 postoperative days. These patients have been excluded from the analysis of long-term survival, since in the more recent trials postoperative deaths were excluded prior to randomization. In the 132 patients remaining, the 5 year survival rate by the life-table method was 23.0%. The tumor of each was classified pathologically by the TNM system. Five-year survival rates for each category were as follows: T1 N0 M0 59.9%, T1 N1 M0 31.3%, T2 N0 M0 27.9%, T2 N1 M0 9.0%, and any T3 or N2 3.6%. The effect of postoperative adjuvant chemotherapy was evaluated in each of the trials. No beneficial effect of the adjuvant therapy was noted with a one or two course regimen of either nitrogen mustard or cyclophosphamide, but possible benefit, although not significant, was noted in a prolonged intermittent chemotherapy trial of cyclophosphamide either alone or alternating with methotrexate. In the most recent trial of prolonged intermittent courses of 1-(2-chlorethyl)-3-cyclohexyl-l-nitrosourea (CCNU) and hydroxyurea, a 5 year survival rate of 80.8% was noted in those receiving adjuvant chemotherapy as compared to a 38.1% in the control group. We conclude that resection is definitely indicated in patients with T1 N0 M0 lesions and probably indicated in those with T1 N1 M0 or T2 N0 M0 lesions. Primary surgical resection is contraindicated in patients with any other TNM category.     

Immunological similarity between a cyanobacterial enzyme and a nuclear DNA-encoded plastid-specific isozyme from spinach

The immunochemical properties of the plastid and cytosolic isozymes of phosphoglucose isomerase (glucosephosphate isomerase; D-glucose-6-phosphate ketol-isomerase, EC 5.3.1.9) in spinach (Spinacia oleracea) and the single phosphoglucose isomerase enzyme from the cyanobacterium Synechococcus sp. were compared by an application of the enzyme-linked immunosorbent assay. Utilizing antibodies made in rabbits against subunits of purified plastid and cytosolic phosphoglucose isomerase isozymes from spinach, we demonstrate that the plastid isozyme is immunochemically more similar to the cyanobacterial enzyme than to the spinach cytosolic counterpart. The antiserum to plastid phosphoglucose isomerase crossreacted strongly with plastid phosphoglucose isomerases from other flowering plants. The antiserum to cytosolic phosphoglucose isomerase crossreacted with other plant cytosolic phosphoglucose isomerase isozymes. The results are consistent with the hypothesis [Weeden, N. F. (1981) J. Mol. Evol. 17, 133-139] that the nuclear gene specifying plastid phosphoglucose isomerase was derived from a prokaryote after the incorporation of a plastid-like symbiont into the ancestral plant cell.     

Predictive factors and mechanism of arrhythmias and myocardial ischaemic changes in elderly patients during barium enema.

The incidence of significant arrhythmias and ST segment changes during barium enema examination (BE) was evaluated by Holter monitoring of 58 unselected patients over the age of 60 years. Forty percent of the group developed new significant arrhythmias of which the most common were frequent and/or multifocal premature ventricular contractions. Seven percent demonstrated ST segment depression. Administration of glucagon did not diminish the incidence of arrhythmias. Predictive factors for ECG abnormalities were advancing age, abnormal pre-BE-ECG, and pre-BE orthostatic hypotension. Analysis of arhythmias and response to phywiologic tension. Analysis of arrhythmias and response to physiologic manoeuvres suggested that the abnormalities were related to increased sympathetic tone which may be intensified by hypovolaemia resulting from routine bowel preparation.