Graft patency and saving the extremity as a function of asymptomatic/symptomatic aneurysm of the popliteal artery and the graft material used

A 27-year experience with 252 popliteal artery aneurysms in 167 patients is reviewed. Long-term results with respect to graft patency and limb salvage rates are analyzed. The results emphasize the importance of early surgical intervention and demonstrate the superiority of autologous saphenous vein over other graft materials.     

Incidence of spontaneous subarachnoid hemorrhage among Hispanics and non-Hispanic whites in New Mexico

Tri(gamma-glutamylcysteinylglycinyl)trithioarsenite (AsIII(GS)3) is formed in cells and is a more potent mixed-type inhibitor of the reduction of glutathione disulfide (GSSG) by yeast glutathione (GSH) reductase than either arsenite (AsIII) or GSH. The present work examines the effects of valence and complexation of arsenicals with GSH or L-cysteine (Cys) upon potency as competitive inhibitors of the reduction of GSH disulfide (GSSG) by yeast GSH reductase. Trivalent arsenicals were more potent inhibitors than their pentavalent analogs, and methylated trivalent arsenicals were more potent inhibitors than was inorganic trivalent As. Complexation of either inorganic trivalent As or methylarsonous diiodide (CH3As(III)I2) with Cys or GSH produced inhibitors of GSH reductase that were severalfold more potent than the parent arsenicals. In contrast, dimethylarsinous iodide ((CH3)2As(III)I) was a more potent inhibitor than its complexes with either GSH or Cys. Complexes of CH3AsIII with GSH (CH3-AsIII(GS)2) or with Cys (CH3AsIII(Cys)2) were the most potent inhibitors, with Ki's of 0.009 and 0.018 mM, respectively. Inhibition of GSH reductase by arsenicals or arsenothiols was prevented by addition of meso-2,3-dimercaptosuccinic acid (DMSA) to a mixture of enzyme, GSSG, and inhibitor before addition of NADPH. DMSA added to the reaction mixture after NADPH reversed inhibition by (CH3)2As(III)I but had little effect on inhibition by CH3As(III)I2, Ch3AsIII(GS)2, CH3AsIII(Cys)2, or AsIII(GS)3. Partial redox inactivation of the enzyme with NADPH increased the inhibitory potency of CH3As(III)I2 and (CH3)2As(III)I and changed the mode of inhibition for CH3As(III)I2 from competitive to noncompetitive. The greater potency of methylated trivalent arsenicals and arsenothiols than of inorganic trivalent As suggests that biomethylation of As could yield species that inhibit reduction of GSSG and alter the redox status of cells.     

Microinjections of anisomycin into the intermediate cerebellum during learning affect the acquisition of classically conditioned responses in the rabbit

Galactosylhydroxylysine (GHL) is released during bone resorption and has been shown to be elevated in subjects with metabolic bone loss. GHL is relatively specific for bone, it is not recycled or significantly metabolized during collagen turnover, and the levels are not influenced by diet. Previous measurements of GHL levels in urine have been performed using reverse-phase high performance liquid chromatography following pre-column derivatization. We produced polyclonal antibodies to GHL using GHL purified from sea sponges and developed an immunoassay that can recognize GHL in urine. The antibodies have minimal cross-reactivity with a physiological mixture of amino acids (< 1%), galactose (< 0.2%), lactose (< 0.3%), and glucosylgalactosylhydroxylysine (< 1%). This competitive immunoassay requires no dilution or pretreatment of the samples and provides a rapid and easy method for the evaluation of GHL in urine. Analysis of clinical samples from normal individuals, post-menopausal women, osteoporotic patients and individuals with Paget's disease show that the assay can discriminate between groups with differing levels of bone resorption as well as deoxypyridinoline (Dpd).     

Pharmacological characterization of the pseudopterosins: novel anti-inflammatory natural products isolated from the Caribbean soft coral, Pseudopterogorgia elisabethae

Pseudopterosin E (PSE), a C-10 linked fucose glycoside and pseudopterosin A (PSA), a C-9 xylose glycoside isolated from the marine gorgonian Pseudopterogorgia elisabethae were both effective in reducing PMA-induced mouse ear edema when administered topically (ED50 (microg/ear) PSE(38), PSA(8)) or systemically (ED50 (mg/kg, i.p.) PSE (14), PSA (32)). Both compounds exhibited in vivo analgesic activity in phenyl-p-benzoquinone-induced writhing (ED50 (mg/kg, i.p.) PSE(14), PSA(4). PSE inhibited zymosan-induced writhing (ED50 = 6 mg/kg, i.p.), with a concomitant dose-dependent inhibition of peritoneal exudate 6-keto-prostaglandin F1alpha (ED50 = 24 mg/kg) and leukotriene C4 (ED50 = 24 mg/kg). In vitro, the pseudopterosins were inactive as inhibitors of phospholipase A2, cyclooxygenase, cytokine release, or as regulators of adhesion molecule expression. PSA inhibited prostaglandin E2 and leukotriene C4 production in zymosan-stimulated murine peritoneal macrophages (IC50 = 4 microM and 1 microM, respectively); however, PSE was much less effective. These data suggest that the pseudopterosins may mediate their anti-inflammatory effects by inhibiting eicosanoid release from inflammatory cells in a concentration and dose-dependent manner.     

Maternal weight gain patterns and birth weight outcome in twin gestation

OBJECTIVE: To evaluate the association between maternal weight gain patterns, based on pregravid body mass index (BMI) and birth weight outcome in twins, and to make specific recommendations for maternal weight gain during twin gestation. METHODS: One hundred eighty-nine twin pregnancies were reviewed retrospectively. Weekly rates of maternal weight gain before 20 weeks, from 20 weeks to delivery, and for total gestation were calculated. Thresholds of weekly maternal weight gain were determined for underweight and normal-weight women. RESULTS: In underweight women, a higher weekly rate of gain before 20 weeks was associated with the birth of both twins weighing at least 2500 g (1.13 versus 0.70 lb/week, P = .017), when compared with mothers of at least one twin weighing less than 2500 g. A higher rate of weight gain from 20 weeks to delivery was associated with the delivery of twins weighing at least 2500 g in both underweight (1.92 versus 1.29 lb/week, P = .031) and normal weight (1.63 versus 1.29 lb/week, P = .046) women. No significant differences in weight gain patterns were found between overweight women delivering twins weighing less than 2500 g or at least 2500 g. A weekly rate of gain from 20 weeks' gestation to delivery of at least 1.75 lb/week in underweight women and at least 1.50 lb/week in normal-weight women was associated with the birth of both twins weighing at least 2500 g. After controlling for other potential determinants of birth weight, the threshold of 1.75 lb/week in underweight women showed a trend toward significance as an independent predictor of both twins weighing at least 2500 g (P = .06). CONCLUSION: Certain maternal weight gain patterns during twin pregnancy are associated with the birth of each twin weighing at least 2500 g. As with singletons, recommendations for maternal weight gain during twin pregnancy can be based on pregravid BMI.     

Improving Predictive Accuracy with a Combination of Human Intuition and Mechanical Decision Aids

This study examines the intuitive combination of human judgment and mechanical prediction under varied information conditions. As expected, mechanical prediction outperformed human intuition when based on the same information, but a combined approach was best when judges had access to relevant information not captured by the model (information asymmetry). The model was useful for differentiating between the event outcomes (improved slope), while eliminating the bias caused by base-rate neglect. Human intuition was useful for incorporating relevant information outside the scope of the model, resulting in improved slope and reduced judgment scatter. The addition of irrelevant information was detrimental to judgment accuracy, causing an increase in bias and a reduction in slope. These results provide insight into how and when combining mechanical prediction and human intuition is likely to result in improved accuracy. Copyright 1998 Academic Press.     

Activation of NMDA receptors stimulates extracellular proteolysis of cell adhesion molecules in hippocampus

Recent work indicates that treatments which block adhesion receptors prevent the stabilization of long term potentiation (LTP). The experiments reported here show that brief stimulation of hippocampal NMDA receptors, a triggering event for LTP induction, results in the extracellular proteolysis of two or more members of the Cell Adhesion Molecule (CAM) family. This effect is rapid, occurs at a consensus serine protease site, and is selective to NMDA receptors. It is also found in vivo after kainic acid induced seizures. Cleavage of adhesive connections could be an early step in the formation of new synaptic configurations.