Interleukin-12 inhibits hepatitis B virus replication in transgenic mice

Interleukin-12 (IL-12) is a heterodimeric cytokine produced by antigen-presenting cells that has the ability to induce gamma interferon (IFN-gamma) secretion by T and natural killer cells and to generate normal Th1 responses. These properties suggest that IL-12 may play an important role in the immune response to many viruses, including hepatitis B virus (HBV). Recently, we have shown that HBV-specific cytotoxic T lymphocytes inhibit HBV replication in the livers of transgenic mice by a noncytolytic process that is mediated in part by IFN-gamma. In the current study, we demonstrated that the same antiviral response can be initiated by recombinant murine IL-12 and we showed that the antiviral effect of IL-12 extends to extrahepatic sites such as the kidney. Southern blot analyses revealed the complete disappearance of HBV replicative intermediates from liver and kidney tissues at IL-12 doses that induce little or no inflammation in these tissues. In addition, immunohistochemical analysis demonstrated the disappearance of cytoplasmic hepatitis B core antigen from both tissues after IL-12 treatment, suggesting that IL-12 either prevents the assembly or triggers the degradation of the nucleocapsid particles within which HBV replication occurs. Importantly, we demonstrated that although IFN-gamma, tumor necrosis factor alpha, and IFN-alpha/beta mRNA are induced in the liver and kidney after IL-12 administration, the antiviral effect of IL-12 is mediated principally by its ability to induce IFN-gamma production in this model. These results suggest that IL-12, through its ability to induce IFN-gamma, probably plays an important role in the antiviral immune response to HBV during natural infection. Further, since relatively nontoxic doses of recombinant IL-12 profoundly inhibit HBV replication in the liver and extrahepatic sites in this model, IL-12 may have therapeutic value as an antiviral agent for the treatment of chronic HBV infection.     

Urine extravasation secondary to upper urinary tract obstruction

To the best of our knowledge, this is the first reported case of renal salvage in a neonate with presumed spontaneous perirenal leakage of urine associated with ureteropelvic junction obstruction. Many instances of such extravasation in this age group have been described with lower urinary tract obstructions. As in the latter cases, the occurrence of extravasation secondary to upper tract obstruction need not preclude primary reconstruction.     

A prospective evaluation of open prefrontal leucotomy

Forty-three patients received an open prefrontal leucotomy for severe and intractable psychiatric illnesses. As a result of the operation three patients died, three developed personality changes and one had repeated grand-mal seizures. Of the 40 patients followed up for six months, 57-5% showed marked improvement in their clinical state and 30-0% mild to moderate degrees of improvement whilst no patient's condition was considered to be worse. Significant improvement was obtained after operation in the mean scores on the Hamilton Anxiety Scale, the Hamilton Depression Scale, the Beck Depression Scale and the Neuroticism Scale of the Eysenck Personality Inventory. Extroversion, as measured by the Eysenck Personality Inventory, was significantly increased after operation. It is recommended that open prefrontal leucotomy procedures be replaced by the safer stereotactic or electrode implantation techniques and that all psychosurgery be confined to specialist units.     

Functioning oxyphil adenoma of parathyroid gland. An ultrastructural and biochemical study

Oxyphil cells and oxyphil cell adenomas of parathyroid glands are, in most instances, regarded to be nonfunctioning. Although 21 cases of hyperparathyroidism associated with parathyroid oxyphil cell adenoma have been reported, secretion of hormone by these tumors has not been conclusively demonstrated. A parathyroid adenoma, diagnosed by light microscopy as oxyphil type, together with the results from ultrastructural and biochemical studies of the patient's adenomatous tissue, are reported here. The patient, a 64-year-old male, was found to have elevated serum calcium, low serum phosphorus, and elevated serum immunoreactive parathormone: findings consistent with hyperparathyroidism. After excision of two small normal-appearing glands and one greatly enlarged (1.9 g) parathyroid gland, those laboratory values returned to normal. Light microscopy of the enlarged parathyroid indicated that it consisted almost entirely of an oxyphil adenoma. Electron microscopy revealed that the adenoma was composed mainly of mitochondria-rich oxyphil cells but also of interspersed transitional oxyphil cells and rare scattered chief cells. Golgi zones, rough endoplasmic reticulum, and prosecretory and secretory-like granules were observed in some oxyphil cells, in most transitional oxyphil cells, and in the infrequent chief cells. Thus, many of these cells appear to contribute to the production and secretion of parathormone. Biochemical studies performed directly on the adenomatous tissue demonstrated that it was able to synthesize proparathormone and parathormone, although the proportion of hormonal peptide synthesis relative to that of the total protein synthesis in this tissue was much smaller (0.9%) than that found in normal parathyroid tissue (5.7%). There was a small increase in immunoreactive parathormone when the adenoma tissue was incubated in a low-calcium medium. These findings indicate that this oxyphil adenoma of the parathyroid gland synthesized and secreted parathormone, apparently to some extent autonomously, but suggest that its capacity to do so was largely dependent on its component of cells other than fully developed oxyphil cells, such as transitional oxyphil cells.     

A model of Weber and noise gain control in the retina of the toad Bufo marinus

We present several variations of a model of gain control in the retina of the toad Bufo marinus, and use them to fit the threshold-vs-intensity data of an actual toad ganglion cell [Donner et al. (1990). Journal of General Physiology, 95, 733-753]. Our models are based on a proposal by Donner et al. that the gain (neural spike per photon ratio) of toad ganglion cells is set by a sequence of two retinal gain control stages. The first stage consists of a Weber gain control mechanism at the level of the red rods. The second is a more proximal "noise gain" stage, which multiplies the (incremental) input signal by a factor that is inversely proportional to the standard deviation of the random ganglion cell input and, under conditions that produce the de Vries-Rose threshold law, is also proportional to the standard deviation of the photon fluctuations within the ganglion cell receptive field. We demonstrate that noise gain control arises naturally from modeling ganglion cell spike generation with either of two common types of spike generation models: integrate-and-fire models or threshold accommodation models. We simulate the process of spike generation in both types of models and show that either model can account for the basic overall shape of the toad t.v.i. curve. However, although integrate-and-fire models appropriately generate noise gain control, they cannot quantitatively fit the threshold data with realistic retinal parameters. Integrate-and-fire models also fail to account for the observed relationship between the generator potential of the ganglion cell and its spiking probability. A threshold accommodation model with realistic retinal parameters, on the other hand, can account for both the threshold data and the generator potential-spike probability relationship. When a Weber gain stage is added to the model at the photoreceptor level, the resulting two-stage gain control model is shown to account quantitatively for the ganglion cell t.v.i. curve of Bufo marinus over the full range of background levels studied by Donner et al.     

Episodes of psychiatric utilization

The continued growth of outpatient psychiatric care has been accompanied by a large number of research studies concerning the determinants of psychiatric utilization. One of the major limitations of these efforts has been the inability to go beyond distributional data on the use of services. This article describes a methodology for generating episodes of psychiatric care given a data set with a small amount of routinely collected data present in many medical information systems. Both demographic and medical characteristics are significantly associated with health services resource use as defined by the number of visits in an episode. A model predicting recurrent episodes of care is also described. The general utility of this approach and the substantive implications of the specific results are discussed.