Suppression of in vitro IgM rheumatoid factor production by diphtheria toxin interleukin 2 recombinant fusion protein (DAB 486IL-2) in patients with refractory rheumatoid arthritis

OBJECTIVE: To investigate the effect of diphtheria toxin interleukin 2 recombinant fusion protein (DAB 486IL-2) on in vitro synthesis of immunoglobulin and rheumatoid factor (RF) in patients with severe refractory rheumatoid arthritis (RA) enrolled in a phase II, double blind, placebo controlled study. METHODS: Anticoagulated venous blood samples were obtained before (Day 1) and after (Day 28) intravenous infusion of either DAB 486IL-2 at 0.075 mg/kg/day (12 patients) or saline placebo (10 patients) on Days 1-5. Peripheral blood leukocytes (PBL) were prepared by density gradient centrifugation, cultured in the presence and absence of pokeweed mitogen (PWM) for one week, and culture supernatants assayed for immunoglobulins and IgM RF by ELISA. RESULTS: Compared to placebo treated patients, PWM induced IgM RF synthesis by PBL decreased after treatment with DAB 486IL-2 (p = 0.043). However, there was no apparent correlation with clinical improvement. PWM induced IgM, IgA, and IgG synthesis also tended to decrease, although the changes did not attain statistical significance. In contrast, PWM induced IgM RF, IgM, IgA, and IgG synthesis by PBL from patients treated with placebo tended to increase during the observation period. Spontaneous immunoglobulin and IgM RF production by PBL from either the DAB 486IL-2 or placebo patients remained stable. CONCLUSION: These observations raise the possibility that DAB 486IL-2 may diminish B cell function either directly or indirectly through effects on T cell function, but the change may not correspond to clinical response.     

Highly active antiretroviral therapy results in a decrease in CD8+ T cell activation and preferential reconstitution of the peripheral CD4+ T cell population with memory rather than naive cells

Criteria for detection of chromosome aberrations by Comparative Genomic Hybridization (CGH) are not standardized and improvement of this part of the analysis is of paramount importance to the applicability of the technique. The aim of this work was to suggest CGH detection criteria that increase the specificity and sensitivity and at the same time include chromosome regions previously excluded from CGH analysis. We analyzed 33 hybridizations with normal DNA and modified our CGH software in order to use a selection of these normal analyses as a model for interpretation of analyses of unknown samples. This approach was successfully tested on 14 samples with known aberrations.     

Biomechanical comparison of the dewar and interspinous cervical spine fixation techniques

STUDY DESIGN: This study evaluates and compares the stiffness of two cervical spine fixation techniques. OBJECTIVES: This biomechanical study was carried out to compare the interspinous and Dewar cervical spine fixation techniques. SUMMARY OF BACKGROUND DATA: Interspinous wiring is a commonly used method of fixation in the cervical spine. The Dewar technique is less commonly known and practiced, and clinical experience has suggested that it may be a more stable technique. METHODS: Cervical spine specimens stabilized with the interspinous and "Dewar" techniques were biomechanically tested in flexion and in torsion. Stiffness and energy absorption under moderate loads were compared. The Dewar technique uses contoured double corticocancellous iliac grafts as internal grafts/splints fixed to the spine with threaded pins and wire. The interspinous technique is a single interspinous wire loop. Eleven fresh human cervical spines were harvested from cadavers. The spines were destabilized at C4-C5 by sectioning all tissue except the anterior longitudinal ligament. Each fixation technique was applied alternatively and tested on each spine. RESULTS: In torsion testing (n = 5), the Dewar fusion was 61% stiffer than the interspinous technique (P < 0.02). Dewar: 11.3 N/mm (s.d. 4.9 N/mm) and interspinous: 8.4 N/mm (SD 3.3 N/mm). In flexion testing (n = 6), the Dewar technique was 35% stiffer than the interspinous technique (P < 0.10). Dewar: 655.4 Nmm/degree (SD 293 Nmm/degree) and interspinous: 406.8 Nmm/degree (SD 113.0 Nmm/degree). Energy absorption with the interspinous technique was greater in flexion (P < 0.10) and in torsion (P < 0.005), indicating more deformation with the interspinous technique. There was no statistically significant difference between the means of specimens tested first and those tested second independently of the fixation technique. CONCLUSIONS: These tests indicate that the Dewar cervical spine fixation is stiffer than the single interspinous wire in both flexion and particularly torsion. This project is the only biomechanical study of the Dewar technique that we are aware of, and the results support the clinical findings regarding the effectiveness of this technique.     

Peculiarities of primary and secondary structure of phage FI-1 DNA

The composition of nitrous bases of phage FI-1 DNA was studied. As is evidenced from the values of buoyant density in CsCl (p=1,7093 g/cm(3)), melting temperature (T degrees m=86,05 degrees), spectral parameters and direct chromatographic determination, the DNA analysed contains 41,5 mole% pairs of guanine-cystosine. 5-hydroxymethylcytosine and other anomalous bases were not found. Chemical identification and jaxtposition of data of buoyant density in CsCl and Cs2SO4 (p=1,4466 g/cm(3)) and T degrees m. showed the presence of the extra-sugar component in DNA, most likely in the form of hentibiose. Spectral character of thermal denaturation of DNA in different solvents is indicative of the double helixity of its structure. DNA is characterized by enthalpies of conformational transitions "helix coil" (deltaH=12,3 kcal/g) and (deltaH=10 kcal/g) for the solvents, 1 x SSC, and 0,1 x SSC, correspondingly. The presence of extra-sugar in DNA with standard set of nitrous bases is discussed.     

Decreased resistance to intravenous tumour-cell challenge during reticuloendothelial depression following surgery

The influence of surgical stress on resistance to i.v. challenge with Walker 256 tumour cells was investigated in rats, with respect to the functional state of the reticuloendothelial system (RES). Phagocytic activity of the RES was evaluated by colloid (gelatinized [131I] "RE test lipid emulsion") clearance, and opsonin levels were determined by bioassay. Reticuloendothelial clearance capacity was significantly (P less than 0-05) depressed 60 min following surgery (coeliotomy plus jejunal enterotomy) as quantified by both humoral and cellular parameters of RE function. Phagocytic depression was primarily due to impaired hepatic Kupffer cell function and related to a deficiency in the phagocytic supporting capacity of plasma, also referred to as opsonic or recognition factor (RF) capacity. During the postoperative period of RES colloid clearance depression, pulmonary localization of the blood-borne test particulate matter increased. Rats challenged with 51Cr-labelled viable tumour cells at a dose of 1-0 X 106 i.v., either prior to or during the postoperative period of RE depression, manifested a significant (P less than 0-05) increment in pulmonary localization of the viable tumour cells, and a decrease (P less than 0-05) in hepatic clearance. Evaluation of survival patterns demonstrated a significant (P less than 0-01) decrease in host resistance to i.v. tumour cell challenge (2 X 103 cells) during the postoperative period of RE depression and hypo-opsonaemia. Sham-anaesthetized control animals survived 17-9 +/- 0-8 days, while animals challenged during the period of RE depression survived 7-9 +/- 0-4 days. An increased incidence of respiratory distress and nasal discharge was observed in the animals with impaired survival. Thus, surgical manipulation may transiently compromise RES systemic host defence and may be reflected in an increment in the pulmonary localization of blood-borne tumour cells. The relationship of this altered pattern of tumour cell distribution to the impaired survival remains to be determined, and warrants investigations.     

Glutamate dehydrogenase activity in the structures of the rabbit brain limbic system

The activity of glutamate dehydrogenase (EC 1.41.1.3) is studied in homogenates and subcellular fractions of five limbic structures: regio superior, regio inferior of hippocampus, fascia dentata, septum and corpora mamillaria. The lowest activity of the enzyme is found in regio superior of hippocampus. 80% of the total enzyme activity of primary fractions is found in "crude" mitochondria. After centrifugation of the latter within the linear sucrose density gradient the distribution of the enzume activity is similar for different structures and the highest activity is found in the region of sucrose molarity from 1.44 up to 1.50 M which corresponds to the mitochondria distribution region. 50% of the total found activity is in the fraction enriched by mitochondria, 30% is in the fraction enriched by nerve endings with the high activity of glutamate decarboxylase. It was found for different fractions that 1 mM of ADF with 0.2 mM NAD-H+ produces about 10-fold increase in the enzyme activity. Pyridoxal-5'-phosphate inhibits the enzyme from inactivation. The results are discussed in connection with the possible role of pyridoxal-5'-phosphate in regulation of the glutamate dehydrogenase activity in vivo.     

A qualitative assessment of the referral system at district level in Zimbabwe: implications on efficiency and effective delivery of health services

This exploratory study describes the nature and magnitude of the problem of health referrals, health-seeking behavior, perceptions, and knowledge at the district level in Zimbabwe. Data were obtained from focus groups with 159 persons in Tsholotsho and 132 persons in Murewa; from discussions with health personnel from the 6 health centers in Murewa and the 2 rural hospitals in Tsholotsho; and from records among a systematic sample of 400 new outpatients during October 1993 and March 1994 in Murewa district. Findings indicate that 71.8% in outpatient departments at Murewa Hospital had no access to a health center. 24.3% by-passed the health center for treatment at the hospital. 3.8% were referred by health centers. The absolute number of referrals did not change during 1991-93. However, the number directly accessing services from outside the district rose. Focus group participants reported their intention to use the nearest clinic for an illness. In Tsholotsho, people initially used the village community worker/headman. If illness was perceived as serious, patients would go to a hospital. For minor illness, people used traditional herbal remedies. If illness did not change after remedies, the clinic was consulted. Some illnesses were perceived as outside the realm of medicine. Most distinguished between a health center and a hospital, but were unaware of the important, superior functions of the health center. Most did not understand the logic behind the referral system, but appreciated referrals and not the cost of hospital treatment or transportation. The community was unaware of Ward Health Teams. Many did not understand the new fee policy introduced in 1994.     

Effects of prenatal androgenization and postnatal steroid treatment on growth hormone, insulin-like growth factor I and II, insulin, thyroxine, and triidothyronine concentrations in beef heifers

A 2 x 3 factorial arrangement of treatments was used to elucidate the mechanism(s) by which prenatal androgenization improves postnatal rate and efficiency of growth and composition of gain in beef heifers. Fifteen control (C) and 15 prenatally androgenized (PA) Angus x Simmental heifers (prenatal treatment, Pretrt) received no (N), estrogen (E), or estrogen and testosterone (ET) implants postnatally (postnatal treatment, Posttrt) to evaluate whether the postpubertal growth response after prenatal androgenization could be induced in prepubertal heifers. Blood was collected from the heifers at 6 +/- 1, 9 +/- 1, and 12 +/- 1 mo of age and analyzed from serum concentrations of growth hormone (GH), IGF-I, IGF-II, insulin, thyroxine (T4), and triiodothyronine (T3). Season of the year had a greater effect on hormone concentrations than either Pretrt or Posttrt, and there were no Pretrt x Posttrt interactions. Prenatal treatment, PA, had no effect on GH; however, Posttrt E and ET increased (P < .001) GH concentrations. Prenatal treatment, PA, increased (P < .05) IGF-I concentrations, and there was a nonsignificant increase (P = .11) in IGF-I concentrations with Posttrt E and ET. Concentrations of IGF-II were unaffected by Pretrt PA; however, they were lower (P < .01) in the Posttrt E and ET groups. Insulin, T4, T3, BW, and ADG were not affected by Pretrt and Posttrt. Concentrations of GH and IGF-I were increased in heifers that received Pretrt PA and(or) Posttrt E and ET in a manner to support improved growth performance; however, BW and ADG were similar. In prepubertal beef heifers, factors in addition to increased GH and IGF-I seem to be necessary for improved growth performance.     

The effect of sequential administration of octreotide alone and octreotide/growth hormone simultaneously on buserelin stimulated ovarian steroid secretion in women with polycystic ovary syndrome

The site of S1-S2 root activation following percutaneous high-voltage electrical (ES) and magnetic stimulation were located by analyzing the variations of the time interval from M to H soleus responses elicited by moving the stimulus point from lumbar to low thoracic levels. ES was effective in activating S1-S2 roots at their origin. However supramaximal motor root stimulation required a dorsoventral montage, the anode being a large, circular surface electrode placed ventrally, midline between the apex of the xiphoid process and the umbilicus. Responses to magnetic stimuli always resulted from the activation of a fraction of the fiber pool, sometimes limited to the low-thresholds afferent component, near its exit from the intervertebral foramina, or even more distally. Normal values for conduction velocity in motor and 1a afferent fibers in the proximal nerve tract are provided.     

Fluorescence studies of the location and membrane accessibility of the palmitoylation sites of rhodopsin

Fluorescent fatty acid labels have been incorporated into the palmitoylation sites of rhodopsin and used to probe the membrane accessibility and location of these sites. The fluorescence properties of anthroyloxy and pyrenyl fatty acids bound to rhodopsin were investigated in a reconstituted vesicle system. Collisional quenching of fluorescence by stearic acid (DSA) labeled with doxyls in the 16, 12, and 5 positions was used to determine the membrane accessibility and disposition of the modifying fatty acids. To properly determine the membrane concentration of these quenchers, the dependence of the Stern-Volmer parameters on both quencher and vesicle concentration was determined. An analysis of these dependences provided a correction for partitioning of the quencher between the aqueous phase and the membrane. After this correction, the relative effectiveness of doxyl quenchers was 16-DSA > 12-DSA > 5-DSA. Parallel studies on free anthroyloxy and pyrenyl fatty acids incorporated into the reconstituted system showed the same dependence on quencher position. These results indicate that the labels at the palmitoylation sites of rhodopsin are situated in the membrane much as a free fatty acid. This anchoring of the palmitates in the membrane results in the formation of a fourth cytoplasmic loop.