Child Health and Pediatric Education in Oklahoma

The University of Oklahoma Medical Center has a comprehensive program of pediatric training, research and patient care. Establishment of the Oklahoma Health Center and its Children's Medical Center on the University campus will provide expanded opportunities for training and research in cooperation with other organizations concerned with child health and development.     

The Effect of Ambulance Diversions on the Development of Trauma Systems

This report examines the complex relationship between the diversion of ambulances within an emergency medical services system andthe management of trauma patients.     

I N M EMORY OF K EITH N EELY,P H D,MPA, EMT-P

Abstract

Objective. We compared the use of two active cooling devices with passive cooling in a moderate-temperature (≈22°C) environment on heart rate (HR) and core temperature (T_c) recovery when applied to firefighters following 20 minutes of fire suppression. Methods. Firefighters (23 men, two women) performed 20 minutes of fire suppression at a live-fire evolution. Immediately following the evolution, the subjects removed their thermal protective clothing and were randomized to receive forearm immersion (FI), ice water perfused cooling vest (CV), or passive (P) cooling in an air-conditioned medical trailer for 30 minutes. Heart rate and deep gastric temperature were monitored every 5 minutes during recovery. Results. A single 20-minute bout of fire suppression resulted in near-maximal mean ± standard deviation HR (175 ± 13 b·min^?1, P; 172 ± 20 b·min^?1, FI; 177 ± 12 b·min^?1, CV) when compared with baseline (p < 0.001), a rapid and substantial rise in T_c (38.2° ± 0.7°, P; 38.3° ± 0.4°, FI; 38.3° ± 0.3°, CV) compared with baseline (p < 0.001), and body mass lost from sweating of nearly 1 kilogram. Cooling rates (°C·min) differed (p = 0.036) by device, with FI (0.05 ± 0.04) providing higher rates than P (0.03 ± 0.02) or CV (0.03 ± 0.04), although differences over 30 minutes were small and recovery of body temperature was incomplete in all groups. Conclusions. During 30 minutes of recovery following a 20-minute bout of fire suppression in a training academy setting, there is a slightly higher cooling rate for FI and no apparent benefit to CV when compared with P cooling in a moderate temperature environment.     

Thrombocytopoietic properties of oncostatin M

Oncostatin M (OM) is a 28-kD glycoprotein that exhibits a panoply of biologic effects. Based on histologic observations of increased splenic megakaryocytes in nude mice implanted with an OM-secreting cell line, the thrombocytopoietic properties of OM in mice were investigated in culture and in vivo. Alone, OM did not induce megakaryocytic colony formation, but in combination with murine interleukin-3 (IL-3), OM markedly enhanced colony formation. The effects of OM on colony formation were similar to those of IL-6. OM alone augmented acetylcholinesterase in short-term marrow cultures. In normal mice, the administration of OM augmented platelet counts without increasing other circulating blood cell counts. The increment in counts exceeded that observed with IL-6. The kinetics of the OM response suggested that maximal increases in platelets occurred 3 days after the cessation of OM administration, irrespective of the duration of administration. In irradiated mice, OM administration accelerated platelet recovery and prevented the decrease in red blood cells observed in irradiated control animals. The data show that OM behaves as a megakaryocytic maturation factor in vitro and augments platelet production in vivo. Based on these animal data, OM may have potential clinical utility as a thrombocytopoietic agent.     

Occurrence of the t(2;5)(p23;q35) in non-Hodgkin's lymphoma

Primary CD30(Ki-1)-positive anaplastic large-cell lymphoma (ALCL) is considered by some to be a distinct clinicopathologic entity associated with the t(2;5) (p23;q35). However, the specificity of t(2;5) for ALCL has not been carefully studied. Therefore, we performed a detailed analysis of all cases of ALCL with abnormal cytogenetics results in the Nebraska Lymphoma Study Group registry, as well as all other cases of non-Hodgkin's lymphoma with t(2;5) in the registry. We found the t(2;5) in only five of 10 cases of ALCL, four of whom were young patients. However, we also found the t(2;5) in 11 other cases of nonanaplastic lymphoma, including eight children with typical peripheral T-cell lymphomas of various types. The t(2;5) was also found in three older adults with B-cell lymphomas of various types. Thus, the t(2;5) was not specific for CD30+ ALCL. However, t(2;5) may define a clinicopathologic entity in children and young adults characterized by variable morphologies with a T-cell or indeterminate phenotype, CD30-positivity, nodal disease with frequent extranodal involvement, advanced stage, and an excellent response to therapy, including bone marrow transplantation for relapsed disease. The clinical relevance of the t(2;5) in older patients requires further study.     

Expression of the gene for the atrial natriuretic peptide in cardiac myocytes in vitro

Summary Primary cultures of neonatal cardiocytes expreses the gene for atrial natriuretic peptide (ANP). In general the levels of expression follow the rank order: atrial > ventricular nonmyocardial cells. Following the initial dispersion cardlocytes require 48 to 72 hours before ANP seeretion and ANP mRNA accumulation approach a new steadystate level. In situ hybridization analysis indicates that ANP gene expression is concentrated in a subpopulation of cardiocytes in both the atrial and the ventricular cell cultures. These findings suggest that these primary cultures may be of value in defining the faciors governing the expression of the ANP gene in the cardiac cell.