Human T Lymphocytes Require Lipid as Either Lipoprotein or Nonesterified Fatty Acid for In Vitro Activation

Serum, which is required for activation of T cells in vitro, was fractionated to isolate and identify major supportive components. The serum activity concentrated exclusively with the lipoprotein fractions LDL and HDL. Furthermore, oleic and linoleic acids were equally active supplements, suggesting that resting T cells may require exogenous lipid because they are incapable of synthesizing fatty acid. A survey of fatty acids disclosed that all were capable of some degree of support. Titration delineated the narrow concentration range of lipid supplements successful in supporting T cell proliferation and demonstrated that concentrations must be rigidly controlled to optimize cell proliferation.     

Pneumocystis carinii pneumonia associated with methotrexate therapy in rheumatoid arthritis

Opportunistic infections occur in patients with rheumatic diseases treated with low dose methotrexate (MTX) with or without other immunosuppressants. Our case report illustrates a fatal case of Pneumocystis carinii pneumonia in a patient with rheumatoid arthritis treated with low dose MTX and glucocorticoid. A review of the literature reveals other opportunistic infections such as Cryptococcus, Nocardia, and herpes zoster presenting in such patients. These occurrences suggest that MTX should be used cautiously in patients with rheumatic disease receiving concomitant medical therapy.     

Effects of bombesin and gastrin-releasing peptide on memory processing

We have previously shown that feeding mice immediately following training enhances memory retention and that one of the gastrointestinal hormones released during a meal, cholecystokinin, also enhances retention after peripheral administration. In the studies reported here we demonstrate that another gastrointestinal peptide, gastrin-releasing peptide (GRP), enhances retention after peripheral administration, as does its amphibian counterpart, bombesin. GRP_14–27 had the same effect as the intact peptide, while GRP_1–16 was ineffective at enhancing retention. The dose-response curves showed a characteristic inverted U-shape with high doses of both GRP and bombesin being amnestic. The effect of both peptides was time-dependent and both reversed amnesia induced by the anticholinergic, scopolamine. I.c.v. administration of the peptides required higher doses to produce an effect on memory retention. suggesting that the effect was mediated predominantly through a peripheral mechanism. Doses of the peptides that enhanced memory retention after peripheral administration failed to increase serum glucose, suggesting that glucose modulation was not the mechanism by which GRP and bombesin modulate memory processing. Vagotomy inhibited the memory-enhancing effects of both GRP and bombesin, suggesting that these peptides produced their effect by stimulating ascending vagal pathways. These studies, together with our previous study with cholecystokinin, suggest the existence of a gastrointestinal hormonal system, which is activated by the passage of food through the intestine, that enhances memory retention.     

Urethral function after chronic cauda equina lesions in cats. I. The contribution of mechanical factors and sympathetic innervation to proximal sphincter dysfunction

We investigated the contribution of mechanical and sympathetic neural factors to proximal urethral sphincter dysfunction in the cat after chronic sacral rhizotomy. Concomitant vesicostomy prevented a decrease in the urethral pressure profile measured three months post-rhizotomy. Sympathetic influences on basal urethral perfusion pressure were the same in neurally-intact and chronic rhizotomised cats. A significant prazosin-sensitive component of basal urethral perfusion pressure remained after section of all extrinsic urethral innervation in both neurally-intact and chronic cats. Local intra-arterial 6-hydroxydopamine also abolished this component. After rhizotomy, noradrenaline content in the proximal urethra was significantly increased but there was no change in sensitivity to sympathetic stimulation. A small (5% of control) atropine-sensitive and prazosin-resistant constriction was seen only after chronic sacral rhizotomy. We conclude that a mechanical factor associated with bladder expression and not an alteration in sympathetic control is the major factor leading to diminished proximal urethral closure after vesicourethral lower motor neuron lesion. Furthermore, short adrenergic neurons have an important role in the maintenance of urethral pressure in the normal state and after lower motor neuron lesion.     

The implementation of audit in an ENT unit

ENT Departments in the United Kingdom are faced with increasing pressure from government, management and the Colleges responsible for surgical training to introduce formal medical self audit. The plethora of guidelines and publications on the subject rarely address the differences in clinical practice between general medicine or surgery and that of otolaryngology. Clearly the lead in the introduction of medical audit will come from the appropriate specialist associations; however, this paper aims to share the experience of the implementation of audit in one otolaryngology, head and neck surgery unit and offer suggestions for a programme elsewhere.     

Comparison of fMRI statistical software packages and strategies for analysis of images containing random and stimulus-correlated motion.

The objectives of this study were to use computer-generated phantoms containing real subject motion to: (1) compare the sensitivity of four commonly used fMRI software packages and (2) compare the sensitivity of three statistical analysis strategies with respect to motion correction. The results suggest that all four packages perform similarly in fMRI statistical analysis with SPM2 having slightly higher sensitivity. The most sensitive analysis technique was to perform motion correction and include the realignment parameters as regressors in the general linear model. This approach applies to all four packages examined and can be most beneficial when stimulus-correlated motion is present.     

Exposure to pesticides in ambient air

Abstract: Ambient air was monitored for pesticides at four sites in Coffs Harbour, a coastal town (population about 50 000) surrounded by banana plantations. Air was sampled continuously for five consecutive months during the peak agricultural spraying period using vacuum pumps set to sample one litre per minute through ORBO-42 adsorption tubes. Six pesticides were detected: three organochlorines and three organophosphates. The most commonly detected pesticide (14 per cent of all samples) was chlor-pyrifos (maximum detected level 208.0 ng/m³, mean 3.6 ng/m³). Heptachlor was detected in 7.1 per cent of all samples (maximum detected level 133 ng/m³, mean 2.7 ng/m³). Other pesticides were only rarely detected. The only pesticide applied by air in the district (propiconazole) was not detected. If international health guidelines are used as a yardstick, these levels of exposure appear unlikely to present an appreciable health risk. Chlorpyrifos detection was associated with low wind speed (P = 0.012) and high temperature (P = 0.015), and detection at one site was associated with detection at another (P < 0.001). Chlorpyrifos detection was also associated with domestic applications within the town area as reported by pesticide applicators (P = 0.045). Peak agricultural use of chlorpyrifos did not coincide with peak detection periods. None of the detected organochlorines is registered for agricultural use, although at the time, heptachlor was permitted for use as a domestic termiticide. Even in a semirural town with nearby widespread use of agricultural chemicals, community exposures to pesticides in ambient air may largely relate to their nonagricultural use.     

Profession and Professionalisation: Part 1: Role and identity of undergraduate physiotherapy educators

The first part of this paper addresses the issues of profession and professionalisation which affect educators in physiotherapy undergraduate studies. It introduces ‘profession’ and ‘professionalisation’ in isolation, although it is not the intention to simplify discussion, but instead to explore the concepts as they stand from a wider perspective before applying them to physiotherapy education. This is followed by a consideration of the complex issues of physiotherapy itself as an aspiring profession, based upon the elements of a profession previously identified, before introducing the role of physiotherapy education and research within the professionalisation process. Part 2 continues this theme by offering a critical analysis of the overlap between education, research and professional status.The second and concluding part of this article continues the theme of professionalisation within physiotherapy, yet more specifically addresses the issues of professionalisation within academia. It provocatively considers physiotherapy academic educators themselves as jugglers of two values – the producers of future professionals and the aspirational creators of a profession. This theme is then expanded by an analysis of the demands placed upon physiotherapy educators, from the perspective both of promoting the profession, and of identifying physiotherapy educators' values. A summary of the discussion follows, outlining emerging points for future development.This paper finally proposes how physiotherapy educators need to revisit the values that underpin their role, and how the professionalisation of future physiotherapists depends upon both a sound understanding and respect of educational philosophy and educational research. The creation and support of a ‘profession’ of physiotherapy educators is offered as a medium through which they can reflect upon and evaluate their own practice within the discipline of education.     

Assessment of the spatial occurrence of childhood leukaemia mortality using standardized rate ratios with a simple linear Poisson model.

Reports of a suspected cluster of childhood leukaemia cases in West Central Phoenix have led to a number of epidemiological studies in the geographical area. We report here on a death certificate-based mortality study, which indicated an elevated rate ratio of 1.95 during 1966-1986, using the remainder of the Phoenix standard metropolitan statistical area (SMSA) as a comparison region. In the process of analysing the data from this study, a methodology for dealing with denominator variability in a standardized mortality ratio was developed using a simple linear Poisson model. This new approach is seen as being of general use in the analysis of standardized rate ratios (SRR), as well as being particularly appropriate for cluster investigations.