Inhibition of IL-1 induced tissue factor (TF) synthesis and procoagulant activity (PCA) in purified human monocytes by IL-4, IL-10 and IL-13

Exposure of monocytes to pro-inflammatory cytokines or lipopolysaccharide (LPS) may induce synthesis and expression of tissue factor (TF). In this paper we have focused on the induction of TF-activity in human monocytes by the pro-inflammatory cytokines recombinant human interleukin 1 (rhIL-1 alpha) (rhIL-1 beta) (rhIL-6) and human tumour necrosis factor alpha (rhTNF-alpha), measured as procoagulant activity (PCA) in a microtitre plate-based clot assay. In addition we have studied the modulation of IL-1 alpha/beta induced TF-mRNA and PCA by rhIL-4, rhIL-10 and rhIL13. IL-1 alpha and IL-1 beta induced a concentration dependent increase in TF-activity. Neither IL-6 nor TNF-alpha gave rise to procoagulant activity at the concentrations tested (0.2-20 ng/ml). IL-4, IL-10 and IL-13, all effectively diminished IL-1 alpha/beta induced PCA, shown at the protein- and at the mRNA-level, while cell viability was unaffected. These results add to the previously demonstrated role of IL-4 and IL-10 as inhibitors of LPS-induced TF-activity, showing that these anti-inflammatory cytokines are not specific for LPS-activation but interfere with other stimulating substances such as IL-1, which may be involved in diseases where LPS is not present.     

Working collaboratively with families

Research studies indicate that significant tension characterizes the relationships between providers and families whose relative is being treated in the mental health system. The author recommends that genuinely collaborative relationships be developed in order that people receiving treatment receive optimal care. Collaboration is defined, barriers identified, and ways to overcome these barriers suggested.     

Two-dimensional echocardiography with a wide angle (60 degrees) sector scanner

A wide angle (60 degrees) sector scanner producing a real-time two-dimensional echocardiogram has been used to examine healthy infants, children, and adults. Its method of use is described and findings from longitudinal and transverse scans are presented. The points of difference between the various types of electronic and mechanical two-dimensional scanning systems are discussed. This equipment minimises problems of chest contact and rib and lung interference and, by providing echocardiograms of high line density from a wide angle, is a suitable real-time two-dimensional scanning system for examining patients of all ages.     

Spectrophotometric determination of diphenhydramine. HC1 in pharmaceutical preparations

A new spectrophotometric method has been developed for determining diphenhydramine. HC1, based on solvent extraction into chloroform of the complex formed with bromocresol green. The complex solution in chloroform showed maximum absorption at 415 nm and obeyed Beer's law over the concentration range of 3.0-12.0 microgram/ml. The molar absorptivity of the complex was 2.02 x 10(4). Complex formation and extraction was complete and quantitative over the pH range from 2 to 5. The ratio of diphenhydramine to bromocresol green was 1:1. Excipients, coloring matter, flavoring agents, and other substances likely to be present in diphenhydramine preparations do not interfere in the determination. Direct determinations in tablet, capsule, sirup, and lotion preparations were carried out satisfactorily, and the average recovery was 100 +/- 1.0%.     

Rotational displacement of the lower tibial epiphysis due to trauma

A rare form of injury to the distal tibial growth plate is described. Only two patients with such an injury have been reported previously. The injury, rotational displacement of the distal tibial epiphysis with posterior displacement of the fibula but without fracture, can be reduced easily and appears to have no lasting ill-effects.