Laparotomy for fulminant pseudomembranous colitis.

Clostridium difficile-associated pseudomembranous colitis is an increasingly common nosocomial infection that usually responds to oral antibiotics. Presentation as an acute abdomen occurred in 12 patients, leading to 14 laparotomies. A distinctive clinical picture was observed: advanced age, recent treatment with antibiotics, fever, abdominal pain, tenderness, marked leukocytosis, and ileus. Only six of the 12 patients had diarrhea. Five were immunosuppressed. Abdominal computed tomographic scans revealed ascites and a massively thickened colonic wall. All four patients treated by subtotal colectomy survived. Four of 10 patients treated only with laparotomy or segmental colectomy died, four responded to medical therapy, and the conditions of two deteriorated but were salvaged by subtotal colectomy. Early diagnosis via endoscopy or computed tomography should obviate the need for exploratory operations. However, progressive toxic effects indicate failure of medical therapy and the need for subtotal colectomy.     

Phosphoproteins of vesicular stomatitis virus: identity and interconversion of phosphorylated forms.

Two proteins of vesicular stomatitis virus (VSV), M (matrix) and NS (nucleocapsid-associated), each contained about the same proportion of phosphoserine and phosphothreonine, with phosphoserine as the principal phosphorylated amino acid. Essentially all phosphate (greater than 98%) present in the NS protein was in a typical phosphomonoester bond, while the M protein contained 10 to 15% of its phosphate in an undetermined linkage. Two forms of the NS protein, NS1, and the more highly phosphorylated NS2 form, were separated in SDS-polyacrylamide gels containing urea, and partially digested with chymotrypsin. A comparison of the chymotryptic peptides indicated that the same two phosphorylated forms, NS1 and NS2, were found in virions as well as in the cytoplasm of infected cells. These two forms were interconvertible in vitro. A conversion of NS2 to the lesser phosphorylated NSl form, presumably by a protein phosphatase activity, occurred in the presence of cytoplasm from either infected or uninfected Chinese hamster ovary (CHO) cells. However the amount of the NS1 species was greatly reduced upon acceptance of phosphate through the action of the virion-associated protein kinase. The products of the kinase reaction were analyzed in more detail by matching phosphopeptides from the partial protease digests of the products with NS and M proteins phosphorylated in vivo. In vitro, M protein was the major phosphate acceptor, while in vivo, NS protein had the greatest capacity to accept phosphate.     

Effect of ovarian hormones on the induction of 1-methyl-1-nitrosourea-induced mammary cancer

The concomitant administration of 20 µg 17ß-estradioland 4 mg progesterone/injection (5 days/week) over a 40-daytreatment period beginning 10 days after methylnitrosourea (MNU)treatment was as effective as ovariectomy in inhibiting mammarycancers (an 84% reduction from non-hormone treated rats). Theprimary action of the hormones must have been directed at preneoplasticcells since the hormones were not given until 10 days afterMNU (a direct-acting carcinogen with a short half-life).     

Social Support, Hardiness and Psychological Well-Being in Women with Arthritis

The purpose of this study of women with rheumatoid arthritis (n = 122) was to determine whether or not social support and hardiness are predictors of psychological well-being when the severity of the women's rheumatoid arthritic disease process is statistically controlled. The findings suggest that satisfaction with social support and hardiness are indeed significant predictors of psychological well-being in women with rheumatoid arthritis, regardless of the severity of illness.