Uptake of ATP by liver and kidney in vitro

Rat liver and kidney slices were incubated at 37 degrees C for 1 h in 1.0 ml of Krebs-HCO3 buffer containing 10mM glucose and one of the following: 5 mM [8-14C]ATP, 5 mM [8-14C]ADP, 5 mM [8-14C]AMP, or 5 mM [8-14C]ation medium and tissue extract were subjected to electrophoretic separation and the radioactivity present in ATP, ADP, AMP, IMP, inosine, adenosine, and hypoxanthine was counted. Extensive degradation of the added nucleotide was observed in the presence of both tissues. The concentrations of 14C-labeled ATP and ADP found in the liver and kidney indicated that these compounds were present within the cells. Evidence is presented which suggests that ATP, and to a lesser extent ADP, entered the liver and kidney as such and were not synthesized within the cell from 14C-labeled adenosine.     

Clinical management of malignant hyperpyrexia

Experience with eight cases of malignant hyperpyrexia are presented. The different types are described and illustrated by clinical cases. Early recognition of this condition is the cornerstone in the successful management of the complication. Early diagnosis and methods of treatment are described.     

Two genes in the rat homologous to human NKG2

OBJECTIVES: The purpose of this study was to investigate the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) genotype and endothelial cell dysfunction or hypercoagulable state in elderly hypertensive patients. BACKGROUND: Angiotensin-converting enzyme (ACE) insertion/ deletion (I/D) polymorphism was recently reported to be associated with various cardiovascular diseases. However, the precise mechanism of this association remains unknown, and some confounding factors might also affect the association. Endothelial cell dysfunction and coagulation activation play important roles in both the atherosclerotic process and the onset of cardiovascular events. METHODS: We identified the ACE I/D genotype and measured the plasma levels of markers of endothelial cell damage (von Willebrand factor [vWF] and thrombomodulin) and of coagulation activation (prothrombin fragment F1 + 2 [F1 + 2]) in 318 asymptomatic elderly patients with hypertension, aged 59-93 years. RESULTS: The vWF level was significantly higher in those with the DD genotype (n = 54) than in those with the II genotype (n = 131, p < 0.0001) or with the ID genotype (n = 133, p < 0.0001). The TM levels were also higher in patients with the ID genotype (p < 0.005) and the DD genotype (p < 0.01) than in those with the II genotype. There were no differences in F1 + 2 level among the groups. Positive correlations of systolic blood pressure with levels of both vWF and thrombomodulin were found predominantly in patients with the II genotype (both p < 0.001), but no correlation was noted in those with the DD genotype. CONCLUSIONS: Considering the increased plasma levels of both endothelial cell-derived markers in the hypertensive patients with ACE DD genotype, we speculate that the ACE D allele is a risk factor for the development of hypertensive cardiovascular disease associated with endothelial cell damage.     

Intracapsular hip fractures. Results of management adopting a treatment protocol

The results of the treatment of 166 patients with intracapsular fractures of the femoral neck during a 30-month period are reviewed. A protocol was adopted whereby patients younger than 65 years of age, together with those with undisplaced fractures, were treated with internal fixation, whereas patients older than 85 years of age were treated with primary hemiarthroplasty. The remaining 120 patients, aged 65-85 years, with displaced fractures were carefully evaluated preoperatively using a scoring system of their physiologic status. The more ambulant and independent patients who were medically fit and mentally alert, with good proximal femoral bone stock, who achieved a physiologic status score (PSS) of 20 or more from a maximum of 26, were managed by reduction and internal fixation of their fractures. Those patients with a PSS below 20 were treated with replacement arthroplasty. At a mean of 21 months postfracture, the mortality was 14%, although, among survivors, there was a low incidence of fracture-related complications, with only 5% of the total group requiring reoperation for infection, internal fixation failure, or prosthetic dislocation. The functional outcome was satisfactory in both treatment groups, although the mean scores for regained mobility and final placement more closely approximated the prefracture scores in the patients undergoing internal fixation. The authors conclude that preoperative assessment of the PSS is a useful guide in determining the appropriate treatment for these fractures, and that internal fixation in the 42% of patients aged 65-85 years with a high PSS appears to be well justified.     

Orbital dermoid cysts: clinicopathologic correlations, classification, and management. The 1997 Josephine E. Schueler Lecture

The dermoid cyst is one of the most common space-occupying orbital lesions, but there has been no large series that details the clinical, pathologic, and therapeutic aspects of this condition. Furthermore, despite the various presentations and types of dermoid cysts, there is no clinically applicable classification of these lesions. We performed a retrospective histopathologic study of 197 consecutive orbital and periorbital dermoid cysts excised at Wills Eye Hospital during a 32-year period, correlated the histopathologic findings with the recorded clinical and radiographic observations, and devised a clinically applicable classification of orbital dermoid cysts. The mean age at excision was 17 years (range, 5 months to 85 years), and the most frequent clinical finding was a painless subcutaneous mass, present in 89% of cases. In 72% of patients, the mass was located in the superotemporal orbital region and produced no abnormalities of vision or intraocular pressure. Computed tomography and magnetic resonance imaging, performed mainly in the more recent cases, disclosed a characteristic round to ovoid cystic lesion with a well-defined lining. Histopathologically, 165 of the cysts (84%) were lined by keratinizing, stratified squamous epithelium. Ten (5%) were lined by nonkeratinizing epithelium resembling conjunctival epithelium. Hair shafts were present in the wall or lumen of the cyst in 195 (99%) of specimens, sebaceous glands in 148 (75%), and sweat glands in 39 (20%); inflammation was present in 75 cases (38%). Based on these personal observations and a review of the literature, a classification of orbital dermoid cysts is proposed that we believe will provide guidance for the ophthalmologist in the management of these lesions.