Prenatal determination of human platelet antigen type using DNA amplification following amniocentesis

OBJECTIVE: To assess the effectiveness of a newly developed individualised birthweight ratio (IBR), which corrects for physiological birthweight determinants, in identifying infants at risk from the complications of macrosomia. DESIGN: Prospective observational study. SETTING: Obstetric unit, Nottingham City Hospital. SUBJECTS: 2835 women delivered between December 1991 and July 1992 and the infants of 624 of these, selected by virtue of their birthweight for gestation and IBR centile positions. MAIN OUTCOME MEASURES: Skinfold thickness and ponderal index measurements, operative delivery, shoulder dystocia, fetal trauma, impaired glucose tolerance. RESULTS: Using an IBR above the 90th centile as a cut off results in 2.4% of infants being reclassified as normally grown and 3.1% are reclassified as large. The IBR does not result in the identification of any more infants with abnormal ponderal indices or skinfold thicknesses than birthweight for gestation. It does, however, identify more of the infants at risk of operative delivery, shoulder dystocia, fetal trauma and impaired glucose tolerance. CONCLUSION: The IBR significantly improves upon birthweight for gestation in identifying infants who suffer from the complications of relative macrosomia.     

Activated partial thromboplastin time and outcome after thrombolytic therapy for acute myocardial infarction: results from the GUSTO-I trial

BACKGROUND: Although intravenous heparin is commonly used after thrombolytic therapy, few reports have addressed the relationship between the degree of anticoagulation and clinical outcomes. We examined the activated partial thromboplastin time (aPTT) in 29,656 patients in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO-I) trial and analyzed the relationship between the aPTT and both baseline patient characteristics and clinical outcomes. METHODS AND RESULTS: Intravenous heparin was administered as a 5000-U bolus followed by an initial infusion of 1000 U/h, with dose adjustment to achieve a target aPTT of 60 to 85 seconds. aPTTs were collected 6, 12, and 24 hours after thrombolytic administration. Higher aPTT at 24 hours was strongly related to lower patient weight (P < .00001) as well as older age, female sex, and lack of cigarette smoking (all PT< .0001). At 12 hours, the aPTT associated with the lowest 30-day mortality, stroke, and bleeding rates was 50 to 70 seconds. There was an unexpected direct relationship between the aPTT and the risk of subsequent reinfarction. There was a clustering of reinfarction in the first 10 hours after discontinuation of intravenous heparin. CONCLUSIONS: Although the relationship between aPTT and clinical outcome was confounded to some degree by the influence of baseline prognostic characteristics, aPTTs higher than 70 seconds were found to be associated with higher likelihood of mortality, stroke, bleeding, and reinfarction. These findings suggest that until proven otherwise, we should consider the aPTT range of 50 to 70 seconds as optimal with intravenous heparin after thrombolytic therapy.     

Further observation of leucocyte migration through the endothelium of venules in the posterior latissimus dorsi muscle of the quail-chick spinal cord chimeras

The migration of leucocytes through the walls of venules was examined in detail in the posterior latissimus dorsi muscle of quail-chick spinal cord chimeras, in which flaccid paralysis of the wings was observed. Examinations were made from the 70th to 80th day after hatching. Muscle fibers were degenerated and intramuscular nerve bundles destroyed. Massive leucocytes (almost lymphocytes) were found around the venules, depending on the passage of wandering leucocytes through the endothelium. Lymphocytes penetrated and were encased in the cytoplasm of the venular endothelial cell, and did not pass through the interendothelial junction. These findings suggest that, in the venules of the atrophied chimeric muscle, wandering leucocytes in the blood may pass through the endothelial cell body and migrate into the inflamed extravascular space.     

Premature separation of centromere and aneuploidy: an indicator of high risk in unaffected individuals from familial breast cancer families?

OBJECTIVES: Injury is the leading cause of death in the male working population of Brazil. An important fraction of these deaths are work related. Very few cohort studies of steel workers, and none from developing countries, have reported on mortality from injuries. This paper analyses mortality from work and non-work related injuries among Brazilian steel workers. METHODS: Deaths during employment from 1 January 1977 to 30 November 1992 were analysed in a cohort of 21,816 male steel workers. Mortality rates specific for age and calendar year among the workers were compared with those of the male population of the state where the plant is located. Work related injuries were analysed by comparing the mortality rates for different subgroups of the cohort. RESULTS: The number of deaths (391) was less than half that expected based on death rates of the general population. Over 60% (242) of deaths were due to injuries. Mortality from most causes was substantially below that in the general population, but that from unintentional injury, was 50% above that of the general population. Standardised mortality ratios (SMRs) were highest for the youngest and the oldest employees and for labourers and clerical workers. Mortality from motor vehicle injury was twice that expected from population rates (SMR = 209, 95% confidence interval (95% CI) 176-244). There was a 67% fall in the age adjusted mortality from occupational injuries in the study period. CONCLUSION: The healthy worker effect in this cohort was greater than that commonly found in studies of occupational groups in developed countries, probably because of a greater socioeconomic gap between employed and unemployed populations in Brazil, and unequal distribution of health care resources. Mortality was especially high for motor vehicle injuries. The fall in mortality from occupational injuries during the study period was probably due to improvement in safety standards, increased automation, and better medical care. There is a need to investigate risk factors for unintentional injuries among steel workers, especially those due to motor vehicle injuries. Prevention of occupational and nonoccupational injuries should be a main priority in Brazil.     

Assay of acyclovir in human skin layers by high-performance liquid chromatography

This paper describes an assay procedure for acyclovir quantification in human skin after in vitro transdermal transport experiments. The procedure employs warm distilled water for acyclovir (ACV) extraction and high-performance liquid chromatography (HPLC) as analytical method. The procedure has good reproducibility, sensitivity and specificity, resulting in a reliable method for biopharmaceutical studies of ACV distribution in skin tissue. The chromatographic conditions set up, using distilled water as mobile phase, makes the analytical procedure simple and easy to perform.     

Application of infrared reflectance spectroscopy to the analysis of milk and dairy products

A method for the rapid, simultaneous determination of protein, fat, carbohydrate, non-protein nitrogen and total solids in milk and liquid dairy products by infrared reflectance spectroscopy is presented. The method is calibrated against known standards obtained by conventional, time-consuming wet chemical methods but, once calibrated, can be operated routinely by non-skilled personnel. The method is sensitive and accurate down to 0·5% w/v and can be applied to most liquid samples without any need for prior preparation.     

Induction of activity and deactivation of Fe, Mn-promoted sulfated zirconia catalysts

The isomerization of n-butane on sulfated zirconia catalysts promoted by the addition of Fe and Mn ions has been studied. The evolution of the catalytic activity of these materials as a function of time on stream exhibits a typical shape containing an induction period during which the activity increases. The induction period is followed by a rapid deactivation and then a slower deactivation. The shape of the conversion—time curves contains important information about the way these catalyst operate. Slight changes in the preparation and pretreatment of the catalysts result in changes in the overall activity and shape of the conversion—time curves. The results of this study suggest that the induction period is due to the formation and accumulation of reaction intermediates on the surface. These intermediates participate in the reaction as part of an inter-molecular mechanism. The n-butane molar fraction, the presence of olefins or hydrogen in the feed, and the reaction temperature strongly affect the induction period.

A simple mathematical model that successfully describes the behavior of the conversion—time curves has been developed. This model is consistent with the existence of two types of sites with different reactivity and stability. One type is responsible for most of the activity observed during the first few minutes on stream, but it is rapidly deactivated. This type of sites is easily deactivated by simple exposure to hydrogen, so it is consistent with an oxidized species recently proposed. The second type of sites is more resistant to deactivation.