THE HALOSCALE "INFANTA" WRIGHT RESPIROMETER: An In Vitro and In Vivo Assessment

The performance of the Haloscale "Infanta" respirometer hasbeen assessed in vitro using ISO test compliances and resistances,and in vivo by comparison with pneumotachograph volumes in 13spontaneously breathing children and 13 children during intermittentpositive pressure ventilation. The Infanta was shown to be capableof registering volumes between 15 and 200 ml with an accuracyof ±5%. The registered volume decreased rapidly below15 ml, whilst above 200 ml over-registration developed.     

Studies of Antibody to Herpes Simplex Virus Fcγ-Binding Protein gE in Patients with Rheumatoid Arthritis, Juvenile Rheumatoid Arthritis and Normal Controls

IgG antibody to gE, the Fc gamma-binding herpes simplex 1 (HSV-1) viral glycoprotein, was studied in 49 rheumatoid arthritis (RA) patients and 43 normal controls. Antibody to gD, another important HSV-1 antigen, was assayed in parallel. No difference between RA patients and normal controls was found in levels of anti-gE antibody measured by reactivity of IgG F(ab')2 fragments reacting with gE coated to ELISA plates. No difference in anti-gD antibody was recorded between normals and patients with RA. Levels of IgG anti-IgE antibody did not correlate with quantitative elevations of serum rheumatoid factor (RF) in RA patients. When IgG anti-gE and anti-gD were assayed in 20 patients with juvenile rheumatoid arthritis and 22 children controls, no significant differences were noted. However, when individual RFs from patients with RA were tested for reactivity against a panel of affinity-isolated F(ab')2 antibodies to gE, some evidence for individual autospecificity was obtained. Four of 20 monoclonal IgM RFs produced from RA patients' B cells showed marked elevations of reactivity with some RA patients' F(ab')2 antibodies to gE. All four of the monoclonal RFs showing this specificity were derived from RA synovial tissue B cells. These findings may provide support for the concept that some RFs in patients with RA show individual specificity for internal image determinants of IgG antibodies to viral Fc gamma-binding proteins.     

ASSESSMENT OF OPIOID DEPENDENCE

Diagnostic criteria for opioid dependence is presented. Five methods are described to assess the presence and/or severity of the opioid dependence syndrome:

• 1 Self-report.
• 2 Physical examination
• 3 Toxicological analysis
• 4 Observation of withdrawal symptoms
• 5 Naloxone (Narcan) test.

Problems in determining actual amounts of heroin in “street deals’ is also discussed. It is emphasised that assessment of heroin-related problems in particular, requires a comprehensive lifestyle assessment in addition to the specific diagnosis of opioid dependence based largely on physical symptomatology as outlined in this paper.     

THE PREVALENCE OF SERUM IgG ANTIBODIES TO TYPE II COLLAGEN IN AMERICAN PATIENTS WITH RHEUMATOID ARTHRITIS

Serum IgG antibody levels to native and denatured bovine typeII collagen were elevated in 31.5 and 21.5% sera respectivelyfrom 200 American patients with RA. The prevalence of serumantibodies to native type II collagen is significantly higherthan previously found in large studies of the prevalence ofthis autoantibody in Britain and Japan when using the same methodology. KEY WORDS: Collagen, Type II, Antibodies     

IS THE CONSTRUCTION OF AN ILEOANAL POUCH ASSOCIATED WITH THE DEVELOPMENT OF ARTHRITIS?

The construction of an ileoanal pouch in patients who have undergonetotal colectomy for ulcerative colitis is claimed to be associatedwith the development of arthritis. The pattern and prevalenceof reported musculoskeletal symptoms in the 15 patients withileoanal pouches attending our hospital was not significantlydifferent to a control group of 60 patients with an ileostomyfor inflammatory bowel disease. There was no clinical or serologicalevidence of arthritis in the eight patients from the study groupreporting symptoms. We conclude that the majority of symptomsoccurring following pouch construction are not attributableto an inflammatory arthropathy. KEY WORDS: Arthritis, Ileoanal pouch     

CALCIUM PYROPHOSPHATE DEPOSITION DISEASE--INVOLVEMENT OF THE ACROMIOCLAVICULAR JOINT WITH PSEUDOCYST FORMATION

Two cases presenting with pseudocyst formation due to pyrophosphatearthropathy involving the acromioclavicular joint are described. KEY WORDS: Chondrocalcinosis, Pseudogout, Acromioclavicular joint     

Evaluation of PTEN expression in cervical adenocarcinoma by tissue microarray

PTEN, a tumor suppressor gene, appears to negatively control the phosphoinositide 3-kinase signaling pathway for regulation of cell proliferation and cell survival. Somatic PTEN mutations are involved in a variety of tumors, including endometrial carcinomas, where PTEN expression is diminished. We examined expression of PTEN in a series of cervical adenocarcinomas and precursors, using tissue microarray (TMA) technology. TMA blocks were constructed using paraffin-embedded, formalin-fixed tissues from 273 samples derived from 16 normal cervical biopsies, 119 cases of invasive adenocarcinoma, and 20 high-grade cervical glandular intraepithelial neoplasia (CGIN). Fresh 3-mum sections were cut and immunostained with PTEN, and expression was correlated with clinicopathologic variables, including histologic subtypes of adenocarcinoma. In 137 patients, PTEN expression was positive in 121 (88%). The intensity and distribution of PTEN staining in the tumor tissue were more heterogeneous than those observed in the normal tissues. There were no significant differences in distribution or intensity of PTEN expression between adenocarcinoma in situ and subtypes of invasive adenocarcinoma. Our findings show that unlike the case in most endometrial carcinomas, PTEN expression is retained during the process of carcinogenesis in the glandular cervix. There is, however, evidence of altered distribution and intensity of PTEN expression in cervical adenocarcinoma cells.     

A ward token system: the illustrated version

In the previous issue of Apex (Vol. 1 No. 3,1973) we described how we had set about developing a positive reinforcement system to develop and maintain self-help and social skills in our children using tokens as conditioned reinforcers. This short illustrated note is to show some of the developments in pictorial form.