Developmental study of ultrastructural and biochemical changes in isolated chick brain microvessels

Expression of progesterone receptor (PR) in various organs of sexually immature chickens and after estrogen treatment was studied by immunohistochemical and Western blotting analyses. Constitutive PR expression was observed in the mesothelium and stroma of the esophagus, proventriculus, liver, spleen, pancreas, heart and lung. In the urogenital tract, PR was expressed in the mesothelial and stromal cells and smooth muscle of blood vessels. Estrogen treatment induced PR expression in the stroma and smooth muscle of the gall bladder and in the epithelium and stroma of the trachea. In the ovary of immature chickens PR was localized in the epithelium, stroma and smooth muscle and was induced in the granulosal cells by estrogen. In most tissues there was more PR-B than PR-A expression and this PR-B dominance remained after estrogen treatment. These results suggest that progesterone and estrogen may have physiological effects on many organs outside the genital tract not previously known as steroid-target tissues.     

Compound heterozygosity for two novel missense mutations in the prothrombin gene in a patient with a severe bleeding tendency

The abnormal prothrombin gene of an Italian patient with a severe bleeding tendency and hypoprothrombinemia was selected for study and compared with the prothrombin genes of healthy controls. All the coding and their flanking regions and the 5'- and 3'-UT regions of the prothrombin gene were screened by analyzing the nucleotide sequence of the corresponding PCR products. The patient was found to be heterozygous for two novel point mutations: one at nucleotide 4251 in exon 6, which changes the codon for cysteine-138 (TGC) in the kringle 1 domain to that for tyrosine (TAC), and one at nucleotide 8812 in exon 10, which results in the replacement of tryptophan-357 (TGG) by cysteine (TGT) in the catalytic domain. Her mother was heterozygous for the Cys-138 Tyr mutation and her father heterozygous for the Trp-357 Cys mutation. Several other sequence variations were identified in the prothrombin genes from control individuals. Only the variations at nucleotide 4203 and 10253 could be established as polymorphisms.     

Valproate prophylaxis in a prospective clinical trial of refractory bipolar disorder

OBJECTIVE: The authors studied the efficacy of valproate plus lithium and of triple therapy with lithium, carbamazepine, and valproate in refractory bipolar illness. METHOD: The subjects were 24 bipolar outpatients who had completed an intended 3-year crossover study comparing lithium, carbamazepine, and their combination. Patients entered a 1-year phase of valproate plus lithium because of inadequate response or major side effects, and patients with inadequate responses were offered an additional year of treatment with all three mood-stabilizing drugs. RESULTS: Six (33%) of the 18 evaluable patients had moderate to marked responses to valproate plus lithium; four of these six had not responded to any previous treatment condition. Three of seven patients responded to triple therapy, although only one response was marked. CONCLUSIONS: Some outpatients with bipolar disorder refractory to lithium and carbamazepine received clinically relevant prophylactic benefit from valproate when used with lithium or in triple therapy.     

Reduced adipose tissue lipoprotein lipase responses, postprandial lipemia, and low high-density lipoprotein-2 subspecies levels in older athletes with silent myocardial ischemia

BACKGROUND: Radioimmunoguided surgery (RIGS) by means of radiolabeled monoclonal antibodies and a probe has been reported to be useful in recognizing subclinical tumor deposits during operation. Aim of this study was to understand the limits of this technique and to assess the potential diagnostic use of RIGS in colorectal cancer surgery. METHODS: Monoclonal antibody B72.3 reacting with TAG 72 antigen, labeled with iodine 125, was injected in 32 patients with primary tumors and in 22 patients with recurrent colorectal cancer. One hundred thirty-three suspected tumor sites were evaluated during operation by means of probe and resected with immunohistochemistry as control. RESULTS: Primary tumor sites were localized by RIGS in 60% of cases, and recurrent sites were localized in 82% of cases. There was a significant correlation both for primary (p < 0.001) and recurrent (p < 0.001) tumor sites between intraoperative RIGS findings and TAG 72 tumor antigen expression. Results obtained with the probe were instrumental in modifying the surgical approach in six (27%) of 22 patients with recurrences, allowing the removal of tumor masses that would otherwise have been overlooked. CONCLUSIONS: The results of RIGS seems to be encouraging in terms of clinical use. The potential high diagnostic resolution appears to improve surgical ablation of colorectal cancer, especially in patients with recurrent cancer or suspected recurrent tumors who have negative results for intraabdominal disease by all other roentgenographic criteria with rising carcinoembryonic antigen or TAG 72 antigen levels.     

Right hepatic lobe atrophy in horses: 17 cases (1983-1993)

The case records of 17 horses with atrophy of the right hepatic lobe were reviewed. Fifteen horses had signs of colic. Two horses had clinical problems that were unassociated with gastrointestinal tract disease. Ages ranged from 5 to 30 years (mean, 12.6 years) and there was no breed or sex predisposition. In clinically normal horses, the right hepatic lobe constitutes half of the total liver weight. The right hepatic lobe in the 17 horses in this study ranged from 11.0 to 38.3% of the total liver weight (mean, 27.8%). Findings on histologic examination of hepatic tissue from horses in the study were variable. Most had loss of hepatocytes, with condensation of hepatic stroma and thick wrinkled hepatic capsules. Additional findings in the horses included torsion of the large colon (15), ileus without gastric rupture (3), typhlocolitis (2), colon infarction secondary to mesenteric strangulation (1), colon infarction secondary to sepsis (1), strangulation of the small intestine from pendulous lipoma (1), and nephrosplenic entrapment (1). No morphologic evidence of angiopathic disease involving the arterial or venous blood supply to the right hepatic lobe was found. Additionally, there was no evidence of biliary tract disease in this portion of the liver. Right hepatic lobe atrophy is believed to result from long-term, insidious, compression of this portion of the liver from abnormal distention of the right dorsal colon and base of the cecum. The practice of feeding horses high-concentrate, low-fiber diets may contribute to atony of the right dorsal colon, with resultant distention that compresses the right hepatic lobe against the rigid, visceral surface of the diaphragm.     

Regional blood flow during pulsatile cardiopulmonary bypass and after circulatory arrest in an infant model

BACKGROUND: Pulsatile perfusion systems have been proposed as a means of improving end-organ perfusion during and after cardiopulmonary bypass. Few attempts have been made to study this issue in an infant model. METHODS: Neonatal piglets were subjected to nonpulsatile (n = 6) or pulsatile (n = 7) cardiopulmonary bypass and 60 minutes of circulatory arrest. Cerebral, renal, and myocardial blood flow measurements were obtained at baseline, on bypass before and after circulatory arrest, and after bypass. RESULTS: Cerebral blood flow did not differ between groups at any time and was diminished equally in both groups after circulatory arrest. Renal blood flow was diminished in both groups during bypass but was significantly better in the pulsatile group than in the nonpulsatile group prior to, but not after, circulatory arrest. Myocardial blood flow was maintained at or above baseline in the pulsatile group throughout the study, but in the nonpulsatile group, it was significantly lower than baseline during CPB prior to circulatory arrest and lower compared with baseline and with the pulsatile group 60 minutes after CPB. CONCLUSIONS: Pulsatile bypass does not improve recovery of cerebral blood flow after circulatory arrest, may improve renal perfusion during bypass but does not improve its recovery after ischemia, and may have beneficial effects on myocardial blood flow during bypass and after ischemia compared with nonpulsatile bypass in this infant model.     

Improving educational preparation for transcultural health care

There is increasing evidence that the health care needs of people from black and ethnic minority groups in England are not being met. A growing number of initiatives are being undertaken to remedy the situation. Many of them are focused on health care delivery at local and national levels. However, unless the preparation of health care professionals in the area of multi-cultural health care is appropriate and effective, a great deal of corrective action will continue to have to be taken. Despite 1997 having been the European Year Against Racism, it is still necessary to consider what educational preparation should be like. The article draws on identified inadequacies in health care provision as well as examples of initiatives taken to improve care provision. The author identifies deficiencies in educational preparation and proposes a range of actions to be taken. The article is focused on nursing, midwifery and health visiting education in England, but is deemed to be relevant to all health care professionals not only in Europe but other continents, as they become increasingly international and multi-ethnic.