A portable precision pumping system for chronic, programmed insulin infusion

This paper provides some details of a new insulin delivery system which includes a reservoir, a pump and a power pack. The reservoir holds 50 ml and is coupled to a precision peristaltic pump whose delivery can be set to any one of 128 different mean flow rates from 0 to 80 microliter/min (+/- 1.6% over 10 months) using the flow rate controller included in the battery power pack. The system weighs 525 g consuming 60 mW at the maximum pumping rate, proportionately less at lower rates. Ten pumps have undergone bench tests for 30 days. One has been subjected to an extended life test of 11 months while seven complete systems have been used on dogs to demonstrate their capability for precise longterm intravenous insulin therapy. With this system experimental diabetes has been reversed in 4 dogs for periods now extending beyond 6 months. This device now qualifies for long-term studies on hospitalized patients with diabetes mellitus.     

Skeletal muscle and cardiac changes with training in patients with angina pectoris

Cardiovascular and skeletal muscle adaptations were studied before and after 6 mo of physical training in patients with coronary artery disease and exertional angina pectoris. Symptom-limited exercise capacity increased by 41% (470 +/- 30 to 665 +/- 35 kg.m.min-1; n = 29, P less than 0.001) with training as did skeletal muscle succinate dehydrogenase activity (1.75 +/- 0.24 to 3.31 +/- 0.24 IU; n = 23, P less than 0.001) and the areas of muscle fibers (type I from 43.6 +/- 3.3 to 54.4 +/- 3.3 micrometers 2 X 10(2); n = 21, P less than 0.05 and type II from 43.9 +/- 2.4 to 57.2 +/- 5.1 micrometers 2 X 10(2); P less than 0.01). At the same submaximal exercise intensity (mean 355 +/- 100 km.m.min-1), plasma catecholamines (1.31 +/- 0.14 to 1.07 +/- 0.09 ng.ml-1; n = 13, P less than 0.05), heart rate (115 +/- 3 to 97 +/- 3 beats/min; n = 29, P less than 0.001), and systolic blood pressure (171 +/- 4 to 143 +2- 4 mmHg; n = 29, P less than 0.001) were significantly reduced after training. Maximal coronary sinus blood flow (192 +/- 10 to 208 +/- 9 ml.min-1; n = 29, P less than 0.05) and left ventricular oxygen consumption (23.2 +/- 1.5 to 25.8 +/- 1.6 ml.min-1; n = 24, P less than 0.05) were increased by 8 and 11%, respectively, after training. The improvement in exercise capacity with training in patients with exercise is secondary to a reduction in myocardial oxygen requirements during subangina levels of exercise and partly to a small increase in maximal myocardial oxygen consumption. The skeletal muscle adaptations with training were not related to other indices of training such as the reduced exercise heart rate or increased symptom-limited exercise capacity.     

Effects of a viral laryngotracheitis on the epithelial barrier of chicken airways

The effects of a virus infection on the barrier function of tracheal epithelium were compared to the effects of a chemical agent (methacholine) which selectively increases membrane permeability, and both were compared to controls. The disruption of the airway epithelium induced by the virus infection caused an increased permeation of horseradish peroxidase (HRP) through this barrier. Methacholine enhanced HRP uptake from the airway lumen to the blood as compared to controls. Visualization of HRP in the tracheal epithelium by transmission electron microscopy correlated with the radioimmunoassay measurements in the blood. Serial anti-HRP antibody titers were measured by a competitive binding technique. The antigen permeation induced by methacholine was associated with an enhanced anti-HRP antibody production. The larger increase in antigen permeation seen with the viral infection was associated with depressed anti-HRP titers. It was concluded that viral disruption of the airway epithelial barrier may contribute to an increased uptake of orally inhaled antigens. The relationship, however, between the increased antigen penetration consequent to the viral infection and the development of allergy remains unclear.     

The effects of hip contact aberrations on stress patterns within the human femoral head

A two-dimensional finite element model incorporating cancellous bone inhomogeneity is used to study femoral head stress alterations caused by changes from the usual articular contact patterns. The contact stress distributions, calculated from an earlier mathematical analysis by Greenwald and O'Connor (16), are found to influence not only the adjacent subchondral bone, but relatively distant parts of the head as well. Both abnormally large joint incongruity and abnormally low cartilage compliance cause load to shift away from the superior “weight-bearing” area, out toward the periphery of the contact region. As a consequence, transverse compressive stresses, which are of appreciable magnitude but which do not contribute to weight bearing, are built up throughout much of the superior and central portions of the femoral head. Most small changes in the overall cartilage thickness or in its thickness distribution, when considered in isolation from hip compliance changes, have only minor effects on the internal stress distribution. An important exception is cartilage thinning at the superior margin, which can result in abrupt longitudinal compressive stress concentrations. It is suggested that such alterations of the normal patterns of stress transmission may contribute to sclerosis or to the formation of osteophytes or cysts in the osteoarthritic hip. This study was aided by grants from the Easter Seal Research Foundation (#N7739), the National Science Foundation (#ENG78-05451), the Barra Foundation, Inc., and the Western Pennsylvania Chapter of the Arthritis Foundation. The authors wish to acknowledge the excellent service provided by the University of Pittsburgh Computer Center. The assistance of Mr. Gary E. Graf and Mrs. Diana W. Montgomery are also appreciated.     

Localization of the disulfide bridges of human histocompatibility antigens.

Both papain-solubilized and detergent-solubilized human histocompatibility antigens have been treated with NTCB (2-nitro-5-thiocyanatobenzoic acid) which cleaves these molecules at cysteine residues. A study of the fragment produced has made it possible to deduce the size and location of the two disulfide loops in these molecules. The sizes of the two loops in HLA-B7 and in the mixture HLA-B7 + 12 are about 5100 and 6600 daltons, a size similar to that of the disulfide loops found in immunoglobulins. The disulfide loops in HLA-A2 may be smaller in size. The two loops are located in middle regions of these molecules; neither the N-terminal nor the C-terminal regions contain disulfide loops.     

Apoptosis, tolerance, and regulatory T cells – old wine, new wineskins

Summary: Antigen‐specific unresponsiveness (or tolerance) has always been an important area of research. Interest in the fate of apoptotic cells and their ability to tolerize has revived interest in some of the older models involving hapten‐modified self. Recently, we have examined the mechanisms by which intravenous injection of trinitrophenol‐coupled spleen cells leads to systemic tolerance. These studies have revealed an important role for Fas/Fas ligand interactions, caspases, CD40/CD40L, and regulatory CD4⁺ and CD8⁺ T cells. Extension of these studies to peripheral deletion of T‐cell antigen receptor transgenic T cells has shown that deletion and active regulation of immune responses may be important mechanisms for the control of potentially damaging autoimmune responses.     

Differentiation of Campylobacter species by protein banding patterns in polyacrylamide slab gels.

Soluble protein extracts of 37 catalase-positive strains of Campylobacter species were examined by polyacrylamide slab gel electrophoresis (PAGE). Electrophoretic banding patterns showed good correlation with biochemical tests and with available DNA homology data in distinguishing species of Campylobacter but did not differentiate subspecies or biotypes. PAGE patterns indicated that Campylobacter coli is a distinct species. Furthermore, the PAGE patterns indicated that C. jejuni and nalidixic acid-resistant thermophilic Campylobacter species (C. laridis) are each distinct species. The protein banding patterns of C. fetus subsp. venerealis and C. fetus subsp. fetus strains were distinctly different from those of the three thermophilic species.     

Polylysine binding to unphosphorylated smooth muscle myosin enhances formation and stabilizes myosin filaments in vitro

Previously, we demonstrated that positively charged polylysine, our model for biological polyamines, activates the Mg2+ ATPase activity of unphosphorylated smooth muscle myosin and shifts the myosin conformation from the folded 10S to linear 6S form. These effects of polylysine were reversed by the oppositely charged heparin (Szymanski et al. (1993) Am J Physiol 265, C379). In the present report, we provide further information on polylysine binding to smooth muscle myosin, and test the hypothesis that polylysine binding to unphosphorylated myosin involves filament formation. To relate the effects of polylysine on contractility in smooth muscle to physiologically relevant material, we investigated the ability of naturally occurring positively charged polyamines, histones, cadaverine, putrescine and spermidine to activate the Mg2+ ATPase activity of unphosphorylated smooth muscle myosin. Our data show that polylysine binding to individual unphosphorylated myosin molecules stimulates formation of myosin filaments. Polylysine also interacts with myosin filaments, causing enhancement of their size and the numbers, and this could be reversed by heparin. Polylysine binding to myosin filaments made them more resistant to disassembly by high salt concentrations (KCl) or ATP. Naturally occurring polyamines in millimolar concentrations activate the Mg2+ ATPase activity of unphosphorylated smooth muscle myosin. We suggest that the electrostatic interactions between naturally occurring positively charged polyamines and unphosphorylated smooth muscle myosin may play a role in stabilization of thick filament structurein situ.     

The incidence of thyroglobulin antibodies and thyroid enlargement in a general practice in north-east England

Antibodies to thyroglobulin in a titre of 1:25 or more were found in 16·2% of women and 4·3% of men between the ages of 21 and 80 years in a random sample of the population from a general practice in the north-east of England. The incidence of antibodies was highest in the seventh decade in both sexes. High antibody titres (1:78125 or more) were found in 4·6% of women and 1·6% of men and it is suggested that this may represent the incidence of diffuse thyroiditis in the population.

Significant thyroid enlargement was found in 12% of women and 0·9% of men, the corrected incidence of goitre obtained by averaging the frequency of goitres in each decade between 21 and 80 years was 8·9% and 0·9% respectively.