Long-term survival in an infant with urethral atresia

Complete urethral atresia is an anomaly that previously was incompatible with life. We report on a surviving infant with this anomaly. As a fetus urinary decompression was accomplished with a vesicoamniotic shunt. Peritoneal dialysis was initiated shortly after birth and at 9 months supramembranous scrotal inlay urethroplasty was performed to provide for egress of urine from the bladder. A maternal renal allograft was performed when he was 12 months old. When the patient was 3 1/2 years old he had normal renal function and emptied the bladder to completion through the reconstructed urethra. Although mildly delayed, he continues to progress with all developmental milestones.     

Protein nutrition and amino acid metabolism after 4 weeks of total parenteral nutrition with a mixture of 14 dipeptides: serendipitous observations on effects of sepsis in baboons

We investigated parameters of nutrition, metabolism, and organ function after 4 wk of total parenteral nutrition (TPN) in baboons receiving either dipeptides or amino acids as the nitrogen source. The two groups showed no significant difference with respect to gain in body weight, nitrogen balance, plasma and muscle concentrations of amino acids, plasma concentrations of proteins, and leucine incorporation into muscle protein. All dipeptides were efficiently utilized as evidenced by trace concentrations of dipeptides in plasma and urine; they produced no deleterious effect on the function of liver, kidney, or immune system. Development of infection in several baboons increased urinary excretion of urea nitrogen but had no effect on urinary excretion of dipeptides and amino acids with the single exception of taurine, which was greatly increased. In conclusion, the data show long-term efficacy and safety of the dipeptide mixture as the sole nitrogen source for TPN.     

Role for interleukin-1 (IL-1) in benzene-induced hematotoxicity: inhibition of conversion of pre-IL-1 alpha to mature cytokine in murine macrophages by hydroquinone and prevention of benzene-induced hematotoxicity in mice by IL-1 alpha

Chronic exposure of humans to benzene (BZ), a myelotoxin, causes aplastic anemia and acute leukemia. The stromal macrophage that produces interleukin-1 (IL-1), a cytokine essential for hematopoiesis, is a target of BZ's toxicity. Monocyte dysfunction and decreased IL-1 production have been shown to be involved in aplastic anemia in humans. Hydroquinone (HQ), a toxic bone marrow (BM) metabolite of BZ, causes time- and concentration-dependent inhibition of processing of the 34-Kd pre-interleukin-1 alpha (IL-1 alpha) to the 17-Kd mature cytokine in murine P388D1 macrophages and BM stromal macrophages, as measured by Western immunoblots of cell lysate proteins using a polyclonal rabbit antimurine IL-1 alpha antibody. HQ over a 10-fold concentration range had no effect on the lipopolysaccharide (LPS)-induced production of pre- IL-1 alpha precursor or on cell viability or DNA and protein synthesis. Stromal macrophages obtained from the femoral BM of C57Bl/6 mice exposed to BZ (600 or 800 mg/kg body weight) for 2 days were incapable of processing the 34-Kd pre-IL-1 alpha to the mature 17-Kd cytokine when stimulated in culture with LPS. Stromal macrophages from mice coadministered BZ and indomethacin, a prostaglandin H synthase (PHS) inhibitor that has been shown to prevent BZ-induced myelotoxic and genotoxic effects in mice when coadministered with benzene were able to convert the pre-IL-1 alpha to mature cytokine. Administration of recombinant murine IL-1 alpha (rMuIL-1 alpha) to mice before a dose of BZ that causes severe depression of BM cellularity completely prevents BM depression, most probably by bypassing the inability of the stromal macrophage in BZ-treated animals to process pre-IL-1 alpha to the mature cytokine.     

Röntgenologische Befunde zur Keimlage und zum Durchbruch der dritten Molaren

Zusammenfassung Keimlage und Durchbruchsweg der dritten Molaren, wie sie auf Orthopantomogrammen zu beobachten sind, wurden analysiert. Die Weisheitszahnkeime wurden nach ihrem Entwicklungsgrad (modifiziert nachGAT) eingeteilt und ihre Position nach den Parametern Platzangebot im retromolaren Raum, Position der M₃ zu den M₂, vertikale Position, vorliegende Rotation, sowie Zahnachsenwinkel M₁–M₃ bestimmt. In einer Querschnittsuntersuchung wurden 445 Orthopantomogramme von 245 Patienten ausgewertet. Die Ergebnisse dieser Untersuchung konnten in einer Longitudinalstudie mit 129 Patienten, bei denen zwei oder mehrere Orthopantomogramme direkt aufeinanderfolgender Entwicklungsstufen vorlagen, bestätigt werden. Es zeigt sich, daß eine sichere Prognose für eine spätere Einstellung oder Verlagerung der dritten Molaren des Unterkiefers, anhand der verwendeten Parameter nicht vor dem Übergang von Zahnbildungsphase 3 auf 4 möglich ist (Abbildung 7). Die Einstellung der oberen dritten Molaren erscheint in dem vorliegenden Patientengut wesentlich problemloser. Abweichungen vom regulären Durchbruchsweg wurden nur bei Weisheitszahnkeimen mit ausgeprägter primär dystoper Keimlage gefunden.

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Summary The position of the tooth follicle and the eruptive path of third molars was analysed with the help of orthopantomograms. The wisdom teeth follicles were classified according to their stage of development, and their position determined by the following parameters: space available in the retromolar area, relation of the third molars to the second molars, their vertical position, observed rotation and also the axial angle between the first and the third molars. A random sample study of 445 orthopantomograms of 245 patients was carried out. The results of this study could be confirmed in a longitudinal study conducted on 129 patients. The impaction of the third molar is a complex multifactorial mechanism. This study showed that it was not possible within the defined parameters, to predict the eruptive patterns of the mandibular third molars, until the transition of the tooth development from stage 3 to stage 4. The eruption of the maxillary third molars appeared to be relatively unproblematic in the study group. Deviations from the normal eruptive path were observed only in wisdom teeth with a pronounced primary ectopic position of the follicle.

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Résumé La position des follicules dentaires des dents de sagesse ainsi que le chemin suivi par les dents en formation ont été examinés tels qu'ils se présentent sur les orthopantomographies. Les follicules dentaires des dents de sagesse ont été classés d'après leur stade de développement et d'après leur position, définie par les paramètres suivants: «place disponible dans la sphère rétromolaire», «position des dents de sagesse par rapport aux dents de douze ans», «position verticale», «rotation constatée», «angle formé par les axes dentaires des dents de six ans jusqu' aux dents de sagesse». 445 orthopantomographies des 245 patients ont été analysées dans une étude horizontale. Les résultats de cette étude ont pu être confirmés par une analyse longitudinale faite à partir de 129 patients. Il apparait qu'on ne peut pas diagnostiquer avec certitude la future mise en place ou le déplacement des dents de sagesse du maxillaire inférieur à partir des paramètres utilisés avant le passage de la phase de formation no. 3 à la phase no. 4 (Fig. 7). La mise en place des dents de sagesse supérieures semble poser beaucoup moins de problèmes chez les patients examinés. Seules les dents de sagesse dont les follicules étaient nettement mal placés dès l'origine ont présenté des déviations dans le chemin suivi par la dent en formation.

     

A one-year follow-up of fatigued patients

To better understand the complaint "fatigue" and the characteristic features of patients who present with this problem, a one-year follow-up study was performed in a county health center. One hundred-fifteen fatigued adults were identified using scores on the Rand Index of Vitality (RIV). One hundred thirty-nine patients of similar age, sex, and socioeconomic status were identified as nonfatigued. One year later, these patients were followed up with a chart review, reassessment of fatigue (by RIV score), and a telephone interview. Seventy-three (64 percent) fatigued and 72 (53 percent) nonfatigued patients provided this information. On the RIV, 31 patients moved from the fatigued group to nonfatigued, and 15 nonfatigued patients' scores changed to the fatigued category. Patients categorized as fatigued in 1984 (by RIV score) returned for office visits more often (mean of 3.85 vs 2.51, P less than .05), and developed significantly more new diagnoses (2.75 vs 1.68, P less than .05) over the follow-up year, compared with those not fatigued. Fatigued patients also had a greater proportion of diagnoses containing a psychologic component than nonfatigued patients. Persistence of fatigue over the year was significantly associated with race and education (nonwhites and those completing high school remaining fatigued). No significant association between marital status, age, sex, employment status, and either the resolution or development of fatigue over the year was found.     

<Emphasis Type="Italic">TCF7L2</Emphasis>variant genotypes and type 2 diabetes risk in Brazil: significant association,but not a significant tool for risk stratification in the general population

Background  

Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population.     

Direct evidence for the involvement of carbohydrate sequences in human sperm-zona pellucida binding

Several lines of evidence indicate that mammalian fertilization is initiated via a binding process that is dependent upon the recognition of oligosaccharide sequences associated with zona pellucida (ZP) glycoproteins. Here, specific chemical and enzymatic methods were employed to modify human ZP and to test their effects on sperm binding in the hemizona assay system (HZA). Periodate oxidation of human ZP under very mild conditions (10 min, 0 degrees C, 1 mM sodium m- periodate) that attacks only terminal sialic acid resulted in a 30% loss of human sperm binding in the HZA [hemizona index (HZI) = 70.2 +/- 10.9, n = 22; P < 0.05]. Periodate oxidation under mild conditions (1 h, 23 degrees C, 10 mM sodium m-periodate) caused a 40% decrease in binding (HZI = 60.8 +/- 10.3; n = 24; P< 0.01). Treatment of human ZP with neuraminidase caused a substantial increase in sperm binding to human ZP (HZI = 297 +/- 45, n = 22; P < 0.01). These findings indicate that there are sialic acid dependent binding sites coexisting with binding sites that are obscured by sialic acid. To determine the periodate sensitivity of these obscured sites, hemizona were first digested with neuraminidase and subsequently subjected to mild periodate oxidation. The combined enzymatic and chemical treatments caused a 79% decrease in sperm binding compared to control hemizona (HZI = 20.7 +/- 4.4, n = 16; P < 0.001). Human sperm-ZP interaction was also increased by digestion of human ZP with endo-beta-galactosidase (HZI = 710 +/- 232, n = 14; P < 0.01), indicating that potential binding sites for spermatozoa are also obscured by lactosaminoglycan sequences. These studies support a definitive role for the involvement of ZP-associated glycans in the binding of human spermatozoa to oocytes.      

The influence of calcium on sodium efflux in squid axons

1. Previous work has shown that the sodium efflux from the axons of Loligo forbesi increases when external sodium is replaced by lithium.

2. The increase in efflux in lithium was unaffected by ouabain but was abolished by removal of external calcium; in these respects it differed from the potassium-dependent sodium efflux which was abolished by ouabain but not reduced by removal of external calcium.

3. Strontium but not magnesium could replace calcium in activating the ouabain-insensitive sodium efflux; lanthanum had an inhibitory effect.

4. Replacing all the external NaCl by choline chloride or dextrose gave a rise in Na efflux which was abolished by ouabain but not by removal of external calcium.

5. The rise in Na efflux resulting from partial replacement of NaCl by dextrose or choline chloride consisted of two components one of which was ouabain-insensitive and calcium-dependent and the other was inhibited by ouabain but calcium-insensitive.

6. The ouabain-insensitive component of the Na efflux was activated by low concentrations of Na, Li or K but inhibited by high concentrations of Na and to a lesser extent Li. The inhibiting effect of high Na was of the kind expected if these ions displace calcium from an external site.

7. The ouabain-insensitive component of the Na efflux was abolished by cyanide, had a Q₁₀ of 2·7; and was roughly proportional to [Na]_i². It was much more variable in magnitude than the ouabain-sensitive, potassium-dependent component of the sodium efflux.

8. The calcium influx increased five to fortyfold when external NaCl was replaced by LiCl or dextrose, the increase for Li being larger than the increase for dextrose.

9. The calcium influx from Na, Li or dextrose sea water was increased three to tenfold by increasing the internal Na about fourfold.

10. The experiments provide evidence for a coupling between an inward movement of calcium and an outward movement of sodium.