The effect of norepinephrine on aortic 42K turnover during deoxycorticosterone acetate hypertension and antihypertensive therapy in the rat

We studied the effects of norepinephrine on 42K turnover in aorta isolated from rats. The rats were given saline to drink and were made hypertensive by injections of deoxycorticosterone acetate (DOC). Other groups of rats received in addition either 6-hydroxydopamine (6-OH-DA) or a regimen of antihypertensives (Anti-Hy) consisting of reserpine, hydrochlorothiazide, and hydralazine. The weight, length, wall thickness, and circumference of the aorta also were measured. DOC hypertension was associated with increased 42K turnover (rate constant for DOC = 0.0164 +/- 0.0009 vs. 0.0090 +/- 0.0002 min-1 in controls). The responses of 42K turnover to low doses of norepinephrine (NE) were increased in DOC with an ED50 of 3.5 +/- 0.8 X 10(-9) vs. 2.7 +/- 0.5 X 10(-8) M in controls. The aortic weight, weight/length, and wall thickness were also increased. Rats treated with DOC plus 6-OH-DA had lower blood pressure and smaller changes in aortic dimensions; however 42K turnover and response to NE were similar to those of the DOC group. The Anti-Hv group exhibited only small increase in 42K turnover and aortic dimensions when compared to controls. It is concluded that DOC hypertension is associated with increased response of 42K turnover to NE which in turn may contribute to increased responses reported for contraction. The Anti-Hy regimen was more effective than 6-OH-DA in reducing the increased 42K turnover and response to NE associated with DOC hypertension.     

Is clubbing a feature of the anti-phospholipid antibody syndrome?

A patient with the anti-phospholipid antibody syndrome and digital clubbing is described. No recognized cause for the clubbing was found. It is suggested that platelet aggregation and microthrombi formation as a result of anti-phospholipid antibody may be involved in the pathogenesis of the digital clubbing. This may be a new feature of the anti-phospholipid antibody.     

Clinical correlates of circulating immune complexes and antibody reactivity in squamous cell carcinoma of the head and neck. The Department of Veterans Affairs Laryngeal Cancer Study Group

PURPOSE: To evaluate the correlation between the presence and titer of host-derived antibody reactivity, circulating immune complexes, and clinical course and prognosis in patients with squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS: Serum samples, obtained from untreated patients with squamous cell carcinoma of the larynx entered onto a multiinstitutional trial, were evaluated for the presence of elevated circulating immune complexes (221 patients) and host-derived antibody directed against two SCCHN cell lines (107 patients). RESULTS: Patients had significantly elevated levels of circulating immune complexes as measured by C1q binding compared with normal controls. Patients with higher levels of circulating immune complexes were less likely to respond to chemotherapy. No correlations were noted between immune complex levels and stage of disease, nodal status, site of disease, recurrence, or survival. Evaluation of native antibody titers for their relationship to clinical correlates showed no statistically significant associations. In sera subjected to immune complex dissociation, patients with moderately or poorly differentiated tumors had significantly higher antibody titers when compared with patients with well-differentiated tumors. Because marked variation in the increase of antibody titers following immune complex dissociation was noted, the ratio of immune complex-dissociated to native antibody titer was examined. Patients with a high ratio had a lower proportion of complete and partial responses to chemotherapy. CONCLUSION: Our results support the conclusion that the formation of tumor-associated immune complexes in patients with SCCHN is associated with a decreased response to chemotherapy.     

Role of cognitively stimulating home environment in children's academic intrinsic motivation: a longitudinal study

The short- and long-term, and direct and indirect, relations between cognitively stimulating home environment and academic intrinsic motivation were investigated in a longitudinal study from childhood through early adolescence. Structural equations modeling was used to test the hypothesis that home environment positively predicts academic intrinsic motivation over this period. It was also hypothesized that home environmental processes would positively predict motivation controlling for socioeconomic status (SES). When children were age 8, home environment (comprising both direct observations and parent report) and SES were measured. Academic intrinsic motivation was assessed at ages 9, 10, and 13. Results supported the hypotheses. Home environment had statistically positive and significant, direct and indirect paths to academic intrinsic motivation from childhood through early adolescence, indicating both short- and long-term effects across these ages. Moreover, home environment was significant above and beyond SES. The findings revealed that children whose homes had a greater emphasis on learning opportunities and activities were more academically intrinsically motivated.     

Treatment of restlessness in dying patients: more than just sedation]

The aim of this study was to evaluate the efficacy of a minimal-intervention smoking cessation program tailored to meet the needs of patients in a pneumology practice. Six-months open study was designed, multicenter, involving four pneumology practices in different Spanish cities. Smokers with or without respiratory disease who consulted a pneumologist were included. Patients were grouped according to their phase in the self-change process toward smoking cessation: precontemplation or contemplation. The level of physical dependence on nicotine was assessed using a revised version of the Fagerstr?m test. CO in exhaled air was also measured. Precontemplators were advised to quit smoking and given a booklet about smoking addiction. Contemplators were additionally given a practical guide to quitting. Advice on quitting was different for the two different phases. Smokers were reexamined twice: 8 weeks and 6 months later. We evaluated the success of the physician's intervention of encouragement to abstain (a level of CO in exhaled air [10 ppm was required]) and we recorded change of phase in the cessation process. Three hundred thirteen subjects were enrolled: 222 men (70.9%) and 91 women (29.1%). After 6 months, 40 (43%) of the precontemplators had changed phase and 21 of them (23%) had stopped smoking; 61 (28%) of the 221 contemplators had changed phase and 20 of them (9%) had quit smoking. Personalized minimal intervention in subjects with or without disease gives good results in terms of success in quitting as well as progress toward cessation.     

Iron-deficiency anemia and infant development: effects of extended oral iron therapy

Ceramide is a lipid second messenger implicated in the mechanism of apoptotic cell death. The effect of the cell-permeable ceramide analogue C2 has been tested on primary cortical cultures of neurons, astrocytes, and oligodendrocytes as well as on the bipotential glial precursor cell line CG-4. After 24 hr of treatment, C2 ceramide induced a dose-dependent cell death in primary oligodendrocytes and precursor cells, with a maximum effect at 10 microM. Commitment of oligodendrocytes to cell death occurred within the first 6 hr of treatment. Ultramicroscopic analysis of primary oligodendrocytes exposed to C2 ceramide for 3.5 hr revealed extensive membrane blebbing in the absence of nuclear condensation. In contrast, similar treatment of primary neuronal or astrocytic cortical cultures had no effect on cell survival. Neurons and astrocytes were resistant to 10 microM C2 ceramide. Furthermore, bipotential progenitors that were differentiated toward astrocytes also became resistant to ceramide treatment as they acquired a mature astrocytic phenotype. These experiments suggest that cell type specific factors are required for ceramide-mediated cell death in the nervous system.     

Local overexpression of TIMP-1 prevents aortic aneurysm degeneration and rupture in a rat model

Although matrix metalloproteinases (MMPs) are expressed in abundance in arterial aneurysms, their contribution to arterial wall degeneration, dilation, and rupture has not been determined. We investigated MMP function in a rat model of aneurysm associated with arterial dilation, elastin loss, medial invasion by mononuclear inflammatory cells, and MMP upregulation. Rupture was correlated with increased gelatinase B (MMP-9) and activated gelatinase A (MMP-2). Syngeneic rat smooth muscle cells retrovirally transfected with tissue inhibitor of matrix metalloproteinases (TIMP)-1 cDNA (LTSN) or with the vector alone as a control (LXSN) were seeded onto the luminal surface of the vessels. The seeding of LTSN cells resulted in TIMP-1 local overexpression. The seeding with LTSN cells, but not LXSN cells, decreased MMP-9, activated MMP-2 and 28-kD caseinase and elastase activity, preserved elastin in the media, and prevented aneurysmal degeneration and rupture. We conclude that MMP overexpression is responsible for aneurysmal degeneration and rupture in this rat model and that local pharmacological blockade might be a reasonable strategy for controlling the formation of aneurysms in humans.     

Retinal tears 180 degrees and greater. Management with vitrectomy and intravitreal gas

A new technique for the treatment of giant retinal dialysis of 180 degrees or more has been devised. After the lens and vitreous have been removed via the pars plana, the patient is rotated into a prone position on a special operating table. The retina is unfolded by filling the eye completely with gas and is held in place by gas. The patient is then brought back into the normal supine position, and a scleral encircling procedure is added. The initial success rate of reattachment is 12 out of 14 cases. Afterward, many eyes develop massive periretinal proliferation. After six months or more of follow-up, the retina remained attached in six of 14 cases.