Female premenopausal tophaceous gout induced by long-term diuretic abuse

We describe 3 cases of tophaceous gout affecting premenopausal women. The only precipitating factor to be found was the chronic and unnecessary overuse of furosemide, apparently resulting from a psychological profile of anorexia nervosa. Our cases emphasize the need for physicians to look for hidden abuse of diuretics in the presence of gouty arthritis in menstruating women, especially if tophi are noted.     

Purification and activity of a wheat 9-kDa lipid transfer protein expressed in Escherichia coli as a fusion with the maltose binding protein

The cDNA encoding a wheat (Triticum durum) lipid transfer protein of 9 kDa was inserted into an Escherichia coli expression vector, pIH902, and expressed in the bacteria as a fusion with the maltose binding protein. The fusion protein was then purified to homogeneity and subjected to factor Xa cleavage. Although complete cleavage of the fusion protein was obtained, the expected lipid transfer protein was not recovered; it appears to be degraded during protease digestion. However, a fluorescent lipid transfer assay demonstrated that the fusion protein has an activity identical to that of the wheat-purified lipid transfer protein. Thus, this expression system should allow further understanding of the structure/function relationships of wheat lipid transfer proteins.     

The pharmacological effects of cadmium on skeletal neuromuscular transmission

1. Cadmium (100 microM) blocks neuromuscular transmission by blocking prejunctional voltage dependent calcium channels in a competitive manner. 2. Prolonged exposure to cadmium leads to a block of neuromuscular transmission that is not competitive. 3. Cadmium can increase the spontaneous release of acetylcholine, this release is modified by the cation composition of the bathing solution. 4. Cadmium may enter the nerve terminal via the voltage dependent calcium channels (the L-type calcium channel has been implicated) and exert some of its actions intracellularly. 5. All of the extracellular effects of cadmium can be reversed by cysteine.     

Uniting the past and the future in public health nursing: the Michigan Oral History Project

In 1987 a group of Michigan public health nurses recognized the need to capture the richness of the lives of renowned public health leaders by collecting and preserving their oral histories. With the assistance of the Bentley Collection at the University of Michigan, the Michigan Oral History Project found a home. In this paper, the process of designing and implementing the oral history project is described within the framework of McBride's Orchestrating the Stages of a Career, adapted from the Dalton/Thompson/Price career development model. The steps in selecting interviewers and leaders, conducting the interviews, and keeping track of the completed work are outlined. Finally, the early results and potential uses for the collected data are discussed. This project has special significance in this year for the celebration of the centennial of public health nursing.     

Gallbladder motility and cholecystokinin release during long-term enteral nutrition in patients with Crohn's disease

BACKGROUND: Gallbladder bile stasis during long-term continuous enteral feeding may contribute to the high prevalence of gallstones in patients with Crohn's disease. We therefore examined the effects of continuous enteral nutrition on gallbladder motility and cholecystokinin (CCK) release in six patients. METHODS: Gallbladder volume was measured ultrasonographically for 12 h on days 1 (start), 8, 22 (6-h interruption of enteral feeding), 36, and 43 (end) of enteral feeding. Plasma CCK was assessed at several time points. RESULTS: Initial fasting gallbladder volume was 19.3 +/- 4.5 (mean +/- SEM) ml, which decreased to 4.9 +/- 3.6 ml after start of feeding. CCK increased from 1.5 +/- 0.3 to 3.9 +/- 1.1 pmol/l. On days 8 and 36 the gallbladder was almost completely contracted, and CCK increased to 7.5 +/- 2.7 and 8.3 +/- 2.6 pmol/l, respectively. On days 22 and 43 gallbladder volume increased, and CCK decreased rapidly to fasting concentrations after interruption of feeding. CONCLUSIONS: During continuous enteral nutrition the gallbladder is completely contracted, and CCK concentrations remain elevated. It is therefore unlikely that long-term enteral nutrition contributes to the increased prevalence of gallstones in patients with Crohn's disease.