The modern enigma of radiation enteropathy: sequelae and solutions

With the extended indications for abdominal and pelvic radiation therapy, administered at higher dosage levels, an increased incidence of radiation injury to the intestine can be anticipated. Increased efforts are urgently needed to develop innovative methods in the detection, prevention, and management of radiation-induced intestinal injury. Fifty cases of radiation enteropathy have been reviewed to highlight problems in management and to suggest preventive and therapeutic measures, both surgical and nonsurgical.     

Preferential retention of the mink chromosome group in somatic cell hybrids of Chinese hamster and American mink

The chromosomal complement was studied in 57 independent clones of hybrid cells obtained in six experiments for fusion of Chinese hamster and American mink cells. Various mink chromosomes in hybrids of concern are lost. It is shown when a small number of mink chromosomes are retained in hybrid clones, chromosomes 6, 9, 10, 12, 13, 14 and X segregate in a similar way and are preferentially retained in these clones. When a considerable number of mink chromosomes are detained in hybrid clones, the segregation mode is close to a random one.     

Nitric oxide and beta-adrenergic agonist-induced bronchial arterial vasodilation

In anesthetized sheep, we measured bronchial blood flow (Qbr) by an ultrasonic flow probe to investigate the interaction between inhaled nitric oxide (NO; 100 parts/million) given for 5 min and 5 ml of aerosolized isoetharine (1.49 x 10(-2) M concentration). NO and isoetharine increased Qbr from 26.5 +/- 6.5 to 39.1 (SE) +/- 10.6 and 39.7 +/- 10.7 ml/min, respectively (n = 5). Administration of NO immediately after isoetharine further increased Qbr to 57.3 +/- 15.1 ml/min. NO synthase inhibitor N(omega)-nitro-L-arginine methyl ester hydrochloride (L-NAME; 30 mg/kg, in 20 ml saline given i.v.) decreased Qbr to 14.6 +/- 2.6 ml/min. NO given three times alternately with isoetharine progressively increased Qbr from 14.6 +/- 2.6 to 74.3 +/- 17.0 ml/min, suggesting that NO and isoetharine potentiate vasodilator effects of each other. In three other sheep, after L-NAME three sequential doses of isoetharine increased Qbr from 10.2 +/- 3.4 to 11.5 +/- 5.7, 11.7 +/- 4.7, and 13.3 +/- 5.7 ml/min, respectively, indicating that effects of isoetharine are predominantly mediated through synthesis of NO. When this was followed by three sequential administrations of NO, Qbr increased by 146, 172, and 185%, respectively. Thus in the bronchial circulation, there seems to be a close interaction between adenosine 3',5'-cyclic monophosphate- and guanosine 3',5'-cyclic monophosphate-mediated vasodilation.     

Reflections on replacement

In the United States, the total fertility rate is about 1.9 births per woman, down from a peak of 3.2 a generation ago and below the replacement level of 2.1 children. The proportion of women who will never have children has risen from 8% a generation ago to approximately 18% in 1993. The increase in the proportion of women in the labor force, a proximate explanation of the recent decline in intended fertility, is expected to continue. The demographic consequence is declining population with an older age structure. A pronatalist policy to alleviate this outcome, through monetary transfers from taxpayers to potential parents, is not only unlikely to succeed, it is politically unfeasible. An alternative solution, immediately effective but politically unpalatable, would be a generous immigration policy. Even with replacement level fertility, the population is destined to become much older. This inevitable aging of the population should be countered by appropriate institutional transformations: 1) with lower fertility, a larger proportion of women will be available to participate in the labor force to generate taxes needed to support a larger number of pensioners; 2) the institutional practice of ascribing a dependent status to anyone above a particular age can be changed; 3) concerns that an older labor force will have an obsolete education (and fewer years of it) can be countered by changing access to education. Yet, the most serious question is not merely the net reproduction rate, but producing adequate numbers of new adult citizens with responsibility and technical training in the modern world. The fundamental process of socializing children may be jeopardized by replacing the full-time parent with the hired care-giver, the peer group, and the television set. The attenuation of the bonds between parent and child may devalue the worth of childbearing itself. These portentous consequences deserve consideration.     

Simplified body-surface electrocardiographic maps with depolarization magnitude and direction

A new technique is presented for extracting the magnitude and direction of ventricular depolarization at the body surface from surface electrocardiographic (ECG) map data. Bipolar electrocardiograms were obtained from 36 sites on the chest surface in five normal subjects. The direction and magnitude of depolarization as seen from the chest surface were calculated for 18 body-surface areas centred between electrode positions V1 and V6. Each area was bounded by three electrodes with an electrode spacing of 5 cm. A major depolarization component could be calculated for all triangular areas, with 48% of areas having a smaller second component. The area with the greatest magnitude in each subject had a depolarization vector pointing downwards and to the left, with an average angle to the horizontal of 55 degrees. This was consistent with an average angle of 51 degrees obtained from the subjects' 12-lead electrocardiograms. There was more variability in vector angle between adjacent areas on the right-hand side. At the V5/V6 areas, close to the cardiac apex, the vector component had an upwards orientation in all subjects, opposing the overall downward component of ventricular depolarization. The technique was able to determine local depolarization directions which were in agreement with the normal cardiac vector derived from standard electrocardiography. Reversal of the vector direction close to the cardiac apex and the collision of depolarization components from different directions could be detected. This simple form of body-surface mapping can reduce the essential features of depolarization to a single map, and provide information not directly available from a 12-lead electrocardiogram.