Class II, division 1, case with multiple treatment challenges

IgG antibodies from the sera of some patients with bullous pemphigoid (BP) react with a 180 kDa protein termed BPAg2. Antibodies in BP are directed to an extracellular noncollagenous domain of this protein termed NC16A. Our group has recently shown that a portion of the extracellular domain of BPAg2 is identical to LABD97 on the basis of amino acid sequencing. We evaluated sera from 33 patients with BP with circulating IgG antibodies on indirect immunofluorescence, which stained the epidermal side of split skin with titers ranging from 1:40 to 1:640. Immunoblotting was performed against (i) two preparations of proteins from epidermal extract, one containing BPAg2 and one containing LABD97, and (ii) the recombinant NC16A domain of the BPAg2 protein. Twelve sera reacted with the BPAg2 protein. Ten of these also reacted strongly with the NC16A domain. Nine of the 12 sera also reacted with the LABD97 antigen. Bound antibodies were eluted from the 97 kDa band and reapplied to split skin where they bound to the epidermal side. The eluted antibodies also reacted to the BPAg2 protein from the epidermal extract, but did not react with the NC16A domain on immunoblot. We conclude that these nine sera react with an epitope present within BPAg2 and LABD97 but not within the NC16A domain. This epitope is therefore distal to the previously described epitopes in BP. In BP, epitope spreading may occur and antibodies may be produced that recognize the distal portion of the BPAg2 molecule identical to LABD97 but that do not involve the NC16A domain.     

THE EFFECT OF SUSPENDED SOLIDS ON THE FERMENTATION OF DISTILLER'S MALT WORT

Yeast growth is increased and the initial rate of fermentation is accelerated by the residue of insoluble material which is normally present in distiller's malt wort. The increase in yeast concentration is accompanied by a high glycerol content in the fermented liquor and the formation of higher alcohols, particularly isobutanol and 2-methyl butanol, is also increased. The stimulation of yeast growth is independent of the state of aeration of the wort, suggesting that the effect is not associated with entrainment of oxygen by the solids, and the chemical nature and particle size of the suspended material do not appear to be important. Insoluble solids were without effect when yeast growth was limited by carbohydrate rather than by amino-nitrogen. The results suggest that a combination of electrostatic and absorption forces concentrate yeast cells and amino acids at the solid-liquid interface, increasing the rate of uptake of nutrients by the cell and thus diverting carbohydrate to processes associated with yeast growth.     

Effect of bethanechol or erythromycin on gastric emptying in horses

OBJECTIVE: To investigate the prokinetic effect of bethanechol and erythromycin in the upper gastrointestinal tract of healthy horses by measuring the gastric emptying (GE) rate of a radioactive meal. ANIMALS: 4 healthy adult horses. PROCEDURE: After food was withheld for 12 hours, horses were given 370 MBq of 99mTc-labeled sulfur colloid incorporated into egg albumen and 37 MBq of 111In-labeled diethyltriaminepentaacetic acid in 120 ml of water via nasogastric intubation. Intravenously administered treatments were 0.9% NaCl solution, erythromycin (0.1 or 1.0 mg/kg of body weight), or bethanechol (0.25 mg/kg). All drugs were given in 10 ml of 0.9% NaCl solution. Dual-phase scintigraphic images were obtained by use of a gamma camera. The best-fit function was determined for each study, and the resultant curves were then analyzed by use of least squares nonlinear regression. Two variables, time to 50% emptying of the stomach (T-50) and slope of the emptying curve, were derived from the calculated power exponential equation. CONCLUSIONS: Treatment had a significant (P < 0.05) overall effect on T-50 of solid-phase GE. The T-50 of bethanechol (30.09 +/- 10.01 minutes), erythromycin at 0.1 mg/kg (59.08 +/- 10.01 minutes), and erythromycin at 1 mg/kg (60.50 +/- 10.01 minutes) were significantly shorter than T-50 after saline administration (89.97 +/- 10.01 minutes). There was a trend (P = 0.09) for the slope of solid-phase GE of bethanechol and erythromycin (0.1 mg/ kg; P = 0.37) to be steeper than that of saline solution. For liquid-phase GE, the T-50 and the slope of bethanechol differed significantly (P < or = 0.05) from those for saline solution. CLINICAL RELEVANCE: Bethanechol and erythromycin significantly increased solid-phase GE in healthy horses and may have value for use as prokinetic agents in certain gastrointestinal tract diseases.     

Recognition of kidney glomerulus by dynamic programming matchingmethod

Dynamic programming was applied to locate the glomeruli in microscopic images of kidney tissue section. The glomeruli were modeled by a polygon whose sides could be varied within a given range of lengths. The objects were located by determining the best match of the model according to a so-called optimum criterion in which all possible shapes were evaluated at all possible positions in the input image. The best model was selected according to the maximum average gray level. To increase the probability of obtaining a closed contour, a distance criterion was added and the maximum gray-level requirement was relaxed somewhat. The optimum criterion was modified to include a directionality constraint in which the difference in angle between model segments and the edge values in the image was minimized, thereby increasing the performance of the method. A hierarchical multiresolution strategy was used to reduce calculation time. The cyclical property of a contour is also taken into account     

Neuropharmacology of St. John''s Wort (Hypericum)

OBJECTIVE: A developmental-ecological model was used to explore the psychological adjustment and peer social competencies of maltreated preschool children. METHOD: Enhanced research methods were used that included verification of maltreatment status, multiple-variable matching of comparison children, and contextually relevant assessment. One hundred eight Head Start children, of whom 54 were maltreated, participated. Assessment of social functioning included measurement of peer play interactions, global social skills, peer sociometrics, and teacher and parent ratings of behavior problems. RESULTS: Findings indicated that maltreated children were significantly less interactive in peer play and overall exhibited less self-control and interpersonal skill in social interactions than nonmaltreated children. In addition, maltreated children were more likely than their nonmaltreated peers to receive low sociometric ratings and were found by both teachers and parents to display more internalizing behavior problems than comparison children. CONCLUSIONS: These findings indicate the importance of using developmentally sensitive research methods to inform contextually relevant interventions.     

Measurement of the facet modal reflectivity spectrum in highquality semiconductor traveling wave amplifiers

We demonstrate that the Hakki-Paoli technique, commonly used for measuring single pass gain in semiconductor lasers, can be modified to measure facet modal reflectivity down to 10^-6 in semiconductor laser amplifiers. We also introduce a new technique based on Fourier and Hilbert transformations of the spontaneous emission spectrum (the SET method) which enhances the signal-to-noise ratio and permits modal reflectivity measurements down to 10^-1     

Low-dose radiography of scoliosis in children. A comparison of methods

STUDY DESIGN: Records of 1,582 conventional and computed radiographic examinations performed to evaluate scoliosis were reviewed and compared to determine differences in total radiation burden. OBJECTIVE: This study evaluated the impact of computed radiographic imaging (CRI) on radiation exposure in children undergoing serial spinal radiographs for scoliosis assessment and compared exposure from CRI with that of low-dose film-screen combinations. SUMMARY OF BACKGROUND DATA: CRI permits diagnostic radiographic studies to be performed with a dose reduction of 80%-95% compared to conventional film-screen systems. High speed film-screen systems also permit a significantly lower exposure. Each approach has unique advantages and disadvantages. METHODS: Over 6 years, we performed 1,582 spinal examinations in children 4-14 years old using reduced dosage techniques with computed radiography. The images were obtained with Fuji FCR 101 and Philips PCR/SP systems. The adequacy of diagnostic image quality in the serial evaluation of scoliosis at different exposure levels was evaluated and compared with regular and film-screen systems with speeds ranging from 250 to 1,200. RESULTS: Diagnostic-quality images for evaluating scoliosis can be obtained with doses of 5% or less than required with conventional film-screen systems. Computed radiography provides image quality and dose reduction comparable to a 1,200-speed film-screen system. CONCLUSION: CRI gives satisfactory images at 5% reduction of the standard film-screen dose. Based on comparison with a 1,200 speed film-screen system, CRI provides equal or better image quality at a similar radiation dose. The cost of CRI is higher than for film-screen radiography, but wide latitude and the ability to tailor dose with requirements for image quality are significant advantages for CRI.