The potentiating effect of rheumatoid arthritis serum in the immediate phase of nephrotoxic nephritis

Nephrotoxic nephritis induced in rats was employed as an experimental model to investigate the possible effects of rheumatoid factor on in vivo antigen–antibody reactions. Rats injected simultaneously with rheumatoid arthritis serum and rabbit nephrotoxic globulin showed a three-fold increase in immediate proteinuria compared with rats injected with nephrotoxic globulin alone. This potentiating effect of rheumatoid arthritis serum was evident even when the serum was injected 48 hr after the nephrotoxic globulin and was also apparent to a lesser extent in rats decomplemented by a prior injection of aggregated human IgG. Normal human serum had no effect on the proteinuria produced by a standard dose of nephrotoxic globulin while rheumatoid arthritis serum injected with normal rabbit globulin did not increase urinary protein excretion above baseline levels. In rats injected with rheumatoid arthritis serum and nephrotoxic globulin, human IgM (presumably rheumatoid factor) was detected by immunofluorescence on the glomerular basement membrane along with the nephrotoxic globulin and rat complement and persisted at this site for as long as 42 days after the initial injections. Rheumatoid factor activity was also recovered by elution from glomeruli isolated from rat kidneys 24 hr after the injection of rheumatoid arthritis serum and nephrotoxic globulin.     

Interest in genetic testing among first-degree relatives of breast cancer patients

The recent cloning of a breast-ovarian cancer susceptibility gene (BRCA1), and determination of the locus of a related gene (BRCA2), offers potential for clinical genetic testing for breast cancer susceptibility. This study examined interest in and expectations about an impending genetic test among first-degree relatives (FDRs) of breast cancer patients. One hundred five females completed two structured telephone interviews to assess demographics, breast cancer risk factors, psychological factors, and attitudes about genetic testing for breast cancer susceptibility. Overall, 91% of FDRs said that they would want to be tested, 4% said they would not, and 5% were uncertain. The most commonly cited reasons for wanting genetic testing were to learn about one's children's risk, to increase use of cancer screening tests, and to take better care of oneself. Women with less formal education were motivated by childbearing decisions and future planning to a greater degree than were women with education beyond high school. Most women anticipated a negative psychological impact of positive test results, involving increased anxiety (83%), depression (80%), and impaired quality of life (46%). In addition, 72% of women indicated that they would still worry if they tested negative. In multivariate regression analysis, level of baseline depression was the strongest predictor of an anticipated negative impact of genetic testing (Beta =.15; P,.0001). These results suggest that the demand for genetic testing for breast cancer susceptibility may be great, even among women who are not likely to have predisposing mutations. Prior to widespread availability of such testing, it will be critical to develop informed consent protocols to educate individuals about the benefits and limitations of predictive testing for this multifactorial disease. © 1995 Wiley-Liss, Inc.     

Survival and recovery of physiologic functions after early maternal separation in rats.

Fourteen-day-old rats separated from their mothers have greatly increased survival rates, if provided with a local heat source. Body weight, temperature, cardiac and respiratory rates declined for 3 days in all separated animals, and eye opening was delayed most in those separated at room temperature. In survivors, a second phase followed in which all measures rebounded to levels characteristic of normally mothered infants. Cardiac rate, having fallen 40 percent in the first days after separation, rose to levels higher than normally mothered infants at 21 and 30 days of age. Recovery was not clearly initiated by any singly system studied, although non-survivors showed greater weight and temperature loss and evidence of gross motor deficit during the separation response phase.     

A vertical diffusion method for the microbiological assay of isoniazid

A method is described for the assay of isoniazid in serum and other fluids by diffusion along slopes of Löwenstein-Jensen medium inoculated with tubercle bacilli. The method is convenient, rapid and robust, but is less accurate than diffusion systems for the assay of some other substances.     

Electrophysiological investigation of GABA-mediated inhibition at the hermit crab neuromuscular junction

1. The inhibitory neuromuscular junction of the abductor muscle of the large claw of the hermit crab (Eupagurus bernhardus) was investigated using electrophysiological intracellular techniques in order to elucidate further the relative contributions of the pre- and post-synaptic mechanisms of action of GABA and of neural inhibition.2. The electrical constants of the post-synaptic membrane, calculated using the equations for a `short cable'' model, were characteristic of a poorly developed electrical excitability; the specific membrane resistance was usually < 1000 Ω cm² and the specific membrane capacitance was > 40 μF/cm².3. Stimulation of the excitatory axon to the abductor muscle of the large claw at a frequency of 20 Hz evoked highly facilitating excitatory junction potentials (e.j.p.s); stimulation of the inhibitory axon (60-220 Hz) during the excitatory train elicited inhibition which was manifest as an attenuation of the e.j.p.s.4. The addition of γ-aminobutyric acid (GABA) to the bathing solution produced a dose-dependent reduction of e.j.p. amplitude and membrane resistance. The inhibitory effect of concentrations (5 × 10^-5 and 1 × 10^-4 M) which caused a 40-75% e.j.p. attenuation could largely be accounted for by a post-synaptic action on membrane conductance.5. Experiments with picrotoxin suggest that presynaptic inhibitory mechanisms have an important role in neurally evoked inhibition.6. Picrotoxin (1-5 × 10^-5 M) effectively blocked neural inhibition and the actions of GABA in this preparation, whereas bicuculline proved to be considerably less potent and therefore less useful as a physiological tool for studying GABA-mediated inhibition in crustacea.     

Characterization of CD8+ T cells and microenvironment in oral lesions of human immunodeficiency virus-infected persons with oropharyngeal candidiasis

Oropharyngeal candidiasis (OPC), the most common oral infection in human immunodeficiency virus-positive persons, correlates with reduced blood CD4+ T cells. In those with OPC, CD8+ T cells accumulate at the lamina propria-epithelium interface at a distance from the organism at the outer epithelium. The present study aimed to characterize the tissue-associated CD8+ T cells and tissue microenvironment in both OPC+ and OPC- persons. The results show that the majority of CD8+ T cells possess the alphabeta T-cell receptor, the thymus-derived alphabeta CD8 antigen heterodimer, and similar levels of the alpha(4)beta(7), alpha(4)beta(1), and alpha(e)beta(7) homing receptors. Studies to evaluate the tissue microenvironment showed that in OPC+ persons, the adhesion molecule for T cells to enter mucosa, mucosal addressin cell adhesion molecule, is significantly increased, whereas E-cadherin, which allows T cells to migrate through mucosa, is significantly decreased compared to OPC- persons. These results continue to support a role for CD8+ T cells against OPC under conditions of reduced numbers of CD4+T cells, with susceptibility to infection potentially associated with a dysfunction in mucosal CD8+ T-cell migration by reduced tissue-associated E-cadherin.     

The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms

OBJECTIVE: Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. METHODS: The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. RESULTS: As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. CONCLUSIONS: The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.     

Diagnosis of Ewing's sarcoma and related tumours by detection of chromosome 22q12 translocations using fluorescence in situ hybridization on tumour touch imprints

It is increasingly recognized that the identification of t(11;22)(q24;q12) is a useful aid in the accurate diagnosis of Ewing's sarcoma and related tumours. However, cytogenetic studies have a low success rate and adequate tumour is not always available. This study describes the use of fluorescence in situ hybridization (FISH) to detect translocations at 22q12, the site of the EWS gene involved in t(11;22)(q24;q12), on tumour touch imprints made from true cut core-needle biopsy and frozen tumour. Of the seven tumours analysed, five diagnosed as Ewing's sarcoma or primitive neuroectodermal tumour demonstrated chromosome translocation at 22q12. This is a rapid and reliable method to detect a diagnostically relevant chromosome translocation using minimal amounts of fresh or frozen tumour.