Corneal endothelial cell measurements in megalocornea

A pedigree of megalocornea manifested many of the characteristic features as well as some less common features of the disorder. Endothelial specular microscopy of affected patients disclosed normal endothelial cell densities and morphologic characteristics and increased total endothelial cell populations, suggesting a process of total corneal hyperplasia. In contrast, unpublished data indicate diminished densities in congenital glaucoma, a finding more consistent with corneal distention. We conclude that specular microscopy may be of value in differentiating the two disorders, although larger series are necessary for confirmation.     

Control of food handling by cutaneous receptor input in squirrels

In a complementary neuroanatomical study by Brenowitz in 1980, it was shown that tree squirrels (Sciurus niger) have a higher relative density of mechanoreceptors in their glabrous forepaw skin than do ground squirrels (Spermophilus tridecemlineatus). The main purpose of this sudy was to test the prediction that tree squirrels would depend upon somatic sensory (cutaneous) input from their forepaws to a greater extent than would ground squirrels in food handling behavior. In addition, a series of more general questions about the sensory control of food handling was examined. First, using different sized food items, it was shown that food handling (rate of manipulation) is subject to sensory control, in general. Secondly, comparision of sham-operated groups with groups receiving median nerve (innervating the palmar surface) lesions showed that cutaneous input from the volar surface of the forepaw contributes to the sensory control in both species of squirrels. Thirdly, comparison of lesion effects in the two species showed that, as predicted, tree squirrels depend upon cutaneous input from their volar forepaw to a greater extent than do ground squirrels. Fourthly, by reanalyzing the above data it was shown that there is continued sensory feedback from food items rather than only an initial evaluation of them.     

Quantitative evaluation of somatotrophic cells (SC) in the adenohypophysis of normal and diabetic male Chinese hamsters

Free amino acid determinations in the cerebrospinal fluid of patients with Parkinson's disease or other extrapyramidal disorders showed that in both groups most amino acids were increased. Significantly increased amino acids were neutral and basic amino acids. Amino acid clusters were present and corresponded with the grouping of amino acids in accordance with amino acid transport systems. The amino acids within the clusters showed a remarkable degree of correlation, and there was a notable correlation between the clusters both in the parkinsonian group and in the group of extrapyramidal disorders, but not in a control group. Our data suggest that in a number of extrapyramidal disorders, Parkinson's disease included, a more generalized abnormality exists than neuronal loss only and, in addition, that patients with these neurologic conditions have a common biochemical defect in their amino acid transport systems.     

Multiple choice questions for continuing education in family medicine

Multiple choice questions used in continuing medical education may require characteristics different from those used in tests and examinations. The questions of three continuing education exercise were assessed by 48 board certified family physicians. Each physician answered one third of the questions and then judged them on usefulness in patient management, as discriminators of quality of medical care, and on educational value. The relevance of each question was determined by a composite index based on these factors. The content of each question was independently analyzed by three physicians. Relevant questions tended to be those concerned with surgery, symptoms, and management, and those requiring more than simple factual recall. Questions on office management or concerning specific diagnoses were considered less relevant. Neither the manner of asking the question nor the severity of the illness appeared to influence relevance. This information should benefit those developing continuing education programs for family physicians, especially those designed for self-administered individual learning.     

Fatal anaphylactic reaction to tetracycline in the postoperative period

A case of anaphylactic reaction in the form of acute cyanosis, hypotension with sudden and unexpected death of a patient in the post-operative period following the administration of tetracycline is described. There was no history of previous exposure to the drug.     

Desire for euthanasia or physician-assisted suicide in palliative cancer care.

Objective: To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death. Design: In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively. Main Outcome Measures: Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns. Results: There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p = .010), reduced functional status (p = .024), a diagnosis of major depression (p     

A Jordan control canonical form for singular systems

A canonical form for controllable singular systems modulo restricted system equivalence is presented. The canonical form respects the decomposition of the singular system into a regular and an impulsive part. The construction is based on Popov's control canonical form and on the Jordan canonical form recently developed by Hinrichsen and Prätzel-Wolters. Continuity properties are analysed and the cellular partition of the orbit space induced by the canonical form is briefly discussed.     

Schedule-dependent interaction of doxorubicin, paclitaxel and gemcitabine in human breast cancer cell lines

We showed previously that a sequential treatment with doxorubicin (4 hr) followed by paclitaxel (24 hr) (Dox-->Pacl) induces a synergistic cytotoxic effect in the BRC-230 breast cancer cell line and in human primary breast cancer cultures. The validity of this experimental finding was confirmed in a clinical phase I/II study on advanced breast cancer patients. To improve the cytotoxic effect obtained by the Dox-->Pacl sequence, we analyzed the effect of adding gemcitabine (Gem) to the Dox-->Pacl sequence in a preclinical study. Our study was performed on BRC-230 and MCF-7 cell lines, and cytotoxic activity was evaluated by the sulforhodamine B assay and the type of drug interaction by Drewinko's test. When Gem (0.01 microg/ml for 24 hr) was given immediately or 24 hr after Dox-->Pacl, an antagonistic cytotoxic effect was observed. Conversely, a synergistic effect was found when Gem was given 48 hr after Dox-->Pacl. From results of flow cytometric analysis, the synergistic effect was attributed to cell cycle perturbation. Cells were arrested in G2-M (95% in treated vs. 21% in control samples) 24 hr after Dox-->Pacl treatment. The block progressively recovered thereafter, and after a further 24 hr, at the time of Gem treatment, the cells progressed into the G1-S phase boundary (the cell cycle phase susceptible to the cytocidal effect of the drug). Our findings suggest that the interactions of Dox, Pacl and Gem are highly schedule- and time-dependent and should be taken into consideration in the planning of clinical protocols.     

Light-dependent changes in outer segment free-Ca2+ concentration in salamander cone photoreceptors

Simultaneous measurements of photocurrent and outer segment Ca2+ were made from isolated salamander cone photoreceptors. While recording the photocurrent from the inner segment, which was drawn into a suction pipette, a laser spot confocal technique was employed to evoke fluorescence from the outer segment of a cone loaded with the Ca2+ indicator fluo-3. When a dark-adapted cone was exposed to the intense illumination of the laser, the circulating current was completely suppressed and fluo-3 fluorescence rapidly declined. In the more numerous red-sensitive cones this light-induced decay in fluo-3 fluorescence was best fitted as the sum of two decaying exponentials with time constants of 43 +/- 2.4 and 640 +/- 55 ms (mean +/- SEM, n = 25) and unequal amplitudes: the faster component was 1.7-fold larger than the slower. In blue-sensitive cones, the decay in fluorescence was slower, with time constants of 140 +/- 30 and 1,400 +/- 300 ms, and nearly equal amplitudes. Calibration of fluo-3 fluorescence in situ from red-sensitive cones allowed the calculation of the free-Ca2+ concentration, yielding values of 410 +/- 37 nM in the dark-adapted outer segment and 5.5 +/- 2.4 nM after saturating illumination (mean +/- SEM, n = 8). Photopigment bleaching by the laser resulted in a considerable reduction in light sensitivity and a maintained decrease in outer segment Ca2+ concentration. When the photopigment was regenerated by applying exogenous 11-cis-retinal, both the light sensitivity and fluo-3 fluorescence recovered rapidly to near dark-adapted levels. Regeneration of the photopigment allowed repeated measurements of fluo-3 fluorescence to be made from a single red-sensitive cone during adaptation to steady light over a range of intensities. These measurements demonstrated that the outer segment Ca2+ concentration declines in a graded manner during adaptation to background light, varying linearly with the magnitude of the circulating current.