Studies of human chromosomes by DNA-binding fluorochromes I. The normal chromosome complement

Caspersson's method of labelling chromosomes with DNA-binding fluorescent agents has been applied to the study of human chromosomes. Fluorescence distribution curves of normal metaphase chromosomes treated with quinacrine mustard (QM) were obtained by scanning transparent pictures of the labelled chromosomes in a Beckman Analytrol® an instrument normally used for scanning electrophoresis strips. Representative fluorescence distribution curves of the different chromosomes, as well as one complete "QM karyotype", have been presented. The distribution curves of individual chromosomes appear to be characteristic and reproducible and it was concluded that the technique of fluorescent labelling holds great promise for identification of individual human chromosomes end chromosomal regions.     

Early biochemical and morphological changes of the rat adrenal medulla induced by xylitol

Long-term administration of high doses of xylitol and other polyols in rats has been associated with an increase in adrenal medullary hyperplasia and neoplasia. In order to exclude age-related factors and to differentiate between unspecific stress reactions and direct effects of the compound administered, a model was developed for quantifying early adrenomedullary responses. Male SD rats were fed xylitol (10% or 20% in the diet) for 2 and 8 weeks, and early biochemical changes were correlated with a stereological analysis of the adrenal medulla. At first, the in vivo rate of catecholamine (CA) biosynthesis was slightly decreased (at 2 weeks). This was followed by an increase in dopamine--hydroxylase (DBH) activity (at 8 weeks). By that time, the total chromaffin cell volume had increased and the number of chromaffin cells per reference volume had decreased in a dose-dependent way. The total number of chromaffin cells per adrenal gland showed a distinct tendency towards an increase. Adrenal epinephrine and norepinephrine contents were not altered, and both tyrosine hydroxylase and phenylethanolamine-N-methyltransferase activities remained unchanged. These data suggest that continued xylitol administration evoked an inhibitory effect on CA synthesis that, together with stimulation of the adrenal medulla brought about by the compound, resulted in compensatory medullary hypertrophy and hyperplasia.     

Systematic and local reactions during phlebography of the leg with special reference to postphlebographic complications. Randomized, prospective, intraindividual double-blind study of iopamidol and ioxithalamate (250 mg I/ml) using the 125I-fibrinogen test: II

The rate of positive 125I-fibrinogen accumulations after typical ascending phlebography was significantly less (9/40 = 23%) with iopamidol compared with ioxithalamate (16/40 = 40%). The iodine content of the contrast media used in this intraindividual study (40 patients) was 250 mg/ml. With the 125I-fibrinogen uptake accepted as a method of reference, the clinically observed postphlebographic symptoms of thrombophlebitis were false positive in 1/6 and false negative in 3/4 of the cases. These incidences were registered for both contrast media. With the lowered iodine content (250 mg/ml), too, pain reactions were seen in approx. 50% during the injection of the ionic agent, but in none of the cases using the non-ionic agent. Not one of the commercial contrast media can be regarded as "ideal" at this time. Nevertheless, it can be concluded, that non-ionic contrast media with iodine content of 250 mg/ml are highly effective in preventing acute and delayed reactions. Moreover, this concentration seems to be adequate for optimal imaging in phlebography.     

The role of bone marrow microRNA (miR) in erythropoietic dysfunction after severe trauma

BackgroundPrevious data has shown that severe traumatic injury is associated with bone marrow dysfunction, which manifests as persistent injury-associated anemia. This study sought to identify whether the expression of erythropoiesis-related microRNAs were altered in the bone marrow of trauma patients to determine if these microRNAs play a role in persistent injury-associated anemia.MethodsBone marrow was collected from severely injured trauma patients who underwent fracture fixation as well as patients who underwent elective hip replacement. There were 27 trauma patients and 10 controls analyzed. Total RNA and microRNA were isolated from CD34-positive cells using the RNeasy Plus Mini kit, and genome-wide microRNA expression patterns were assayed. Genes with significant expression differences were found using BRB-ArrayTools with a significance of P < .01.ResultsThere were marked differences in expression of 108 microRNAs in the trauma group when compared with hip replacement patients. Four of these microRNAs play a role in regulating erythropoiesis: microRNA-150, microRNA-223, microRNA15a, and microRNA-24. These microRNAs were all upregulated significantly, with trauma/hip replacement fold changes of 1.7, 1.8, 1.2, and 1.2 respectively, and all act to suppress or regulate erythropoiesis.ConclusionAssessment of the bone marrow microRNA profile in trauma patients compared to those undergoing elective hip replacement revealed the differential expression of microRNA-150, microRNA-223, microRNA-15a, and microRNA-24. These microRNAs all play a role in decreased erythroid progenitor cell growth and provide important insight to the erythropoietic dysfunction seen after trauma.     

Designing services for homeless women

The complexity of homelessness suggests that the development of policy and service strategies requires careful analysis of the unique features of identifiable groups within the homeless population. To begin this process, the characteristics and needs of homeless women are specified and their routes to homelessness delineated. Responses to homeless women, with the exception of battered women, have focused primarily on the provision of emergency services. Future policy and services must focus on the adequacy and accessibility of these emergency services as well as the need for transitional and long term housing and social services. The multidimensional nature of homelessness and the heterogeneity of homeless women require a wide range of alternatives that can be tailored to each woman's unique needs for service.     

The extent of Barrett's esophagus depends on the status of the lower esophageal sphincter and the degree of esophageal acid exposure

OBJECTIVE: The purpose of this study was to assess whether the extent of intestinal metaplasia is related to the severity of the gastroesophageal reflux disease. METHODS: A total of 556 consecutive patients with symptoms suggestive of foregut disease had upper gastrointestinal endoscopy with extensive biopsies from the gastroesophageal junction and the esophagus. All patients had esophageal motility and 24-hour pH monitoring. In 411 patients, cardiac-type mucosa was identified; in 147 patients, the cardiac-type mucosa showed intestinal metaplasia. They were divided into 3 groups based on the extent of intestinal metaplasia commonly seen clinically: long segments (>3 cm), short segments (<3 cm), and limited to the gastroesophageal junction. The duration of symptoms, the status of the lower esophageal sphincter, the degree of esophageal acid exposure, and the time to clear a reflux episode were assessed in each group. RESULTS: The presence of intestinal metaplasia in cardiac-type mucosa was associated with the hallmarks of gastroesophageal reflux disease. The extent of intestinal metaplasia correlated strongly with the degree of esophageal acid exposure (r = 0.711; P <.001) and inversely with the lower esophageal sphincter pressure (r = 0.351; P <.001) and length (r = 0. 259; P =.002). Patients with a long segment of intestinal metaplasia (>3 cm) had longer duration of symptoms (16 years) than those patients with a segment of intestinal metaplasia less than 3 cm (10 years; P =.048) or those patients with intestinal metaplasia limited to the gastroesophageal junction (10 years; P =.01). CONCLUSION: The extent of intestinal metaplasia, that is, Barrett's esophagus, is related to the status of the lower esophageal sphincter and the degree of esophageal acid exposure.     

Bupivacaine 2.5 mg/ml versus bupivacaine 0.625 mg/ml and sufentanil l microg/ml with or without epinephrine 1 microg/ml for epidural analgesia in labour

We have compared three different methods of epidural analgesia in labour, bupivacaine 2.5 mg/ml (group B), bupivacaine 0.625 mg/ml + sufentanil 1 microg/ml (group BS) and bupivacaine 0.625 mg/ml + sufentanil 1 microg/ml + epinephrine 1 microg/ml (group BSE). One hundred and forty parturients with a singleton fetus with cephalic presentation were randomly allocated to one of the three groups. Group BSE had significantly less pain than groups B and BS. Group B had a significantly higher degree of motor blockade assessed on the Bromage scale. Significantly, more women in group B required urinary bladder catheterization than in the two other groups and they also had significantly less urge to push during active delivery. The incidence of mild pruritus was 18% in group BS and 36% in group BSE. The frequency of instrumental delivery and caesarean section was low (12% and 6.4%, respectively) with no significant differences between the groups. All women were highly satisfied with the method of analgesia and 97% would prefer the same kind of pain alleviation at the next delivery. We conclude that epidural analgesia with low-dose bupivacaine and sufentanil is as good an analgesic method as high-dose bupivacaine. Addition of low-dose epinephrine improves the analgesia.     

Erfassung muskuloskeletaler Beschwerden mittels Fragebogen

Zusammenfassung Der standardisierte Fragebogen zur Erfassung muskuloskeletaler Beschwerden des japanischen Komitees zum Studium arbeitsbedingter Gesundheitsstörungen im Hals-Arm-Gebiet wurde auf Deutsch übertragen und seine Reliabilität und Validität überprüft. Im Fragebogen wird anhand eines Körperschemas nach der Häufigkeit (nie/selten, gelegentlich, fast täglich) von Beschwerden (Schmerzen, Steifigkeit, Müdigkeit) in 12 Körperregionen gefragt. Der Fragebogen wurde gleichzeitig mit ärztlichen Palpationsuntersuchungen bei 644 Personen aus zwölf Berufsgruppen im Dienstleistungssektor eingesetzt. Auf Grund einer Faktoranalyse der Fragebogenresultate kann festgestellt werden, dass Beschwerden regional getrennt (nämlich im Nacken-Schultergebiet, dem Rücken und je der rechten und linken oberen Extremität) auftreten und für diese Regionen die Symptome zu Indizes zusammengefasst werden können. Diese Indizes sind reliabel (Cronbach 0.8). Mit zunehmenden Indexwerten nehmen schmerzhafte Palpationsbefunde stetig zu. Beschwerden korrelieren mit vermehrtem Medikamentenkonsum und Arztkonsultationen. Der Fragebogen stellt folglich ein valides Untersuchungsinstrument für muskuloskeletale Beschwerden am Arbeitsplatz dar.

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Summary The standardized illustrated questionnaire on musculoskeletal disorders of the Japanese Committee on Occupational Cervico-brachial Disorders was translated into German. This questionnaire, composed of 37 items about the occurrence (never/seldom, occasionally, almost daily) of symptoms (pain, stiffness, fatique) in twelve body regions, was used together with medical examinations (pressure points), and further information was gathered on the consumption of analgetics and medical visits prompted by musculoskeletal symptoms. The questionnaire's reliability and validity were tested in 644 persons from twelve occupational groups within the service sector. Factoranalyses showed that symptoms can be grouped into four distinct regions of occurrence: neck/shoulder/area, back/low back, and both left and right upper extremities. Indices based on these regions are consistent (Cronbach 0.8). Palpation findings steadily increase with increasing index values. The consumption of medicaments and medical visits positively correlate with the indices. Consequently the questionnaire is judged to be a valid instrument for studying musculoskeletal disorders at the workplace.

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Résumé Le questionnaire illustré et standardisé sur les symptômes musculaires et osseux du comité japonais sur la cervico-brachialgie professionelle a été traduit en allemand et sa reliabilité et validité ont été testées. Le questionnaire est composé de 37 variables sur la fréquence (jamais/rarement, par occasion, presque toujours) des symptômes (douleur, raideur, fatigue) dans douze régions du corps. Il était distribué simultanément aux examens médicaux parmi 644 personnes de douze groupes d'employés dans le secteur de service. D'autres informations concernent la fréquence de la consommation des analgésiques et des visites médicales pour des douleurs musculaires. Une analyse factorielle a montré que les symptômes peuvent être groupés en quatre régions du corps: nuque/épaules, dos et les extrémités supérieurs. Les indices sur ces régions sont consistant (Cronbach 0.8). Les douleurs provoquées par la palpation augmentent avec la valeur de l'index. La consommation des analgésiques et les consultations sont correlées avec les indices. Par conséquent, le questionnaire illustré est un instrument valable pour étudier les problèmes musculaires sur les lieux de travail.

     

Improved patient monitoring during intracranial pressure measurement by calculating a theoretical pressure-volume curve]

Patients with an acute "brain damage" where an intracranial pressure rise can be suspected due to the pathophysiological context are an indication for intracranial pressure measurement. For registrating the reduction of the intracranial reserve space before the rise of the medium pressure, volume-loads from the side-ventricles were undertaken with 54 neurosurgical patients. A better bedside monitoring is possible though the mathematical registration of those factors which indicate the size of the functional intracranial reserve space. With the calculated parameters of the reserve space (pressure-volume-index) a theoretical pressure-volume-curve was demonstrated.