Michael Addition Polymerizations of Trifunctional Amines with Divinyl Sulfone

Summary: The mechanisms of the Michael addition polymerization of N‐aminoethyl piperazine (AEPZ) with divinyl sulfone (DVS) were clarified based on the reactivity sequence of three different amines in AEPZ: 2° amine in piperazine ring > 1° amine ≫ 2° amine formed in situ. When the feed molar ratio of DVS to AEPZ was 1:1, the polymerization of AB intermediate formed proceeded, and the linear poly(sulfone amine) containing secondary and tertiary amines in the backbones were produced. The linear structure of the product was confirmed by NMR spectra, and the molecular weights, molecular weight distribution, and properties of poly(sulfone amine)s were characterized by GPC, DSC, and TGA.

Polymerization of linear poly(DVS‐AEPZ).     

Effect of local heat versus ice on blepharoptosis resulting from ocular myasthenia

OBJECTIVE: To determine the effect of heat versus ice application to a ptotic eyelid in patients with ocular or systemic myasthenia. DESIGN: Observational case series. PARTICIPANTS: Three consecutive patients and one subsequent patient with ptosis and clinical or laboratory signs of myasthenia were initially evaluated. METHODS: In all four patients, the heat test and the ice test were performed. In three patients, the modified sleep test was also performed. In the heat or ice test, the patient was asked to hold a heat or ice pack, respectively, over the closed ptotic eye for 10 to 15 minutes. The modified sleep test was performed by having the patient close both eyes for a 10- to 15-minute period. Photographs were taken before and immediately after each test. MAIN OUTCOME MEASURE: The effect of heat or ice on ptosis. RESULTS: Transient complete improvement of ptosis in three patients and marked improvement in one patient was noted after each test. The results of the heat, ice, and modified sleep tests were identical. CONCLUSIONS: Marked improvement of myasthenic ptosis in all four patients occurred regardless of local warming or cooling. The common denominator of all these tests, rest, seems to be the relevant factor in the study as designed.     

Enzyme replacement therapy for infantile hypophosphatasia attempted by intravenous infusions of alkaline phosphatase-rich Paget plasma: results in three additional patients

After biochemical and radiographic studies, enzyme replacement therapy in three patients with the infantile form of hypophosphatasia was attempted by weekly intravenous infusions of bone alkaline phosphatase-rich (BAP) plasma from patients with Paget bone disease. Subsequently, circulating BAP activity was substantially increased in each patient, and in one was maintained in the normal range for nearly 2 months. Despite partial or complete correction of the deficiency of circulating BAP activity, we observed no radiographic evidence for arrest of progressive osteopenia or improvement in rachitic defects in any of the patients. Failure of infants with hypophosphatasia to show significant healing of rickets on correction of circulating BAP activity supports the hypothesis that this isoenzyme functions in situ during normal skeletal mineralization.     

Absorbance of amniotic fluid at 650 nm as a fetal lung maturity test: A comparison with the lecithin/sphingomyelin ratio and tests for disaturated phosphatidylcholine and phosphatidylglycerol

We compared absorbance of amniotic fluid at 650 nm (A₆₅₀) against the lecithin/sphingomyelin ratio, the quantity of disaturated phosphatidylcholine, and the presence or absence of phosphatidylglycerol in 374 uncontaminated amniotic fluid samples. In addition, we studied these measures of fetal lung maturity in 80 pregnancies where neonatal outcomes were known. Statistical analysis revealed a significant association between increasing absorbance and biochemical indices of lung maturation. Our results indicate that A₆₅₀ of amniotic fluid is useful as a measure of lung maturity but that the greatest utility may be for samples with either low absorbance (<0.10) or high absorbance (>0.20). Because of large false positive and false negative values between these two absorbances, other lung maturity estimates should be used when absorbances fall within this range. Therefore, A₆₅₀ may be most useful as a screen or as part of a battery of lung maturity estimates. We are exploring these possibilities as a means of providing better fetal lung maturity estimates.     

Human salmonella carriers in a tropical urban environment

Salmonella sp. were isolated from rectal swab specimens from 39 of 464 (8·4%) of apparently healthy adults and children in central Jakarta, Indonesia. A wide variety of species of Salmonella were found with S. oranienburg predominating. Most of the S. oranienburg isolated were resistant to a wide range of antibiotics, probably because of their previous widespread and inappropriate administration. The yield of carriers identified increased significantly with the use of double enrichment procedures. This study emphasizes the importance of high rates of carriage of Salmonella sp. as potential causes of diarrhoeal disease in overcrowded, unhygienic cities in the tropics.     

An approach to prevention of recurrent diabetic ketoacidosis in the pediatric population

In 1982 we introduced a program designed to prevent recurrent diabetic ketoacidosis (RDKA), based on the assumption that diabetes education in conjunction with appropriate use of and adherence to insulin therapy should eliminate all RDKA. A hierarchical set of medical, educational, and psychosocial interventions was used. The rate of RDKA was lower after initiation of the program even though patients seen during this period came from lower socioeconomic and more one-parent families (each independently associated with RDKA) than patients seen prior to intervention. In 44 patients with a history of RDKA, insulin omission was documented in 31, inadequate education in 13. Overall, the rate of RDKA decreased from a prereferral mean of 25.2 episodes to a postreferral mean of 2.6 episodes per 100 patient-months (P less than 0.0001). Metabolic control improved after intervention as documented by a decrease in mean hemoglobin A1 from 14.1% to 10.7% (P less than 0.0001). RDKA ceased whether or not psychotherapy was used. Although RDKA is causally related to a variety of social, economic, and family dysfunctions, its prevention requires recognition that its proximate cause is omission of insulin and assurance that a support system exists to ensure adherence.