Coffin-Siris syndrome. Review of the literature

A great deal of new information has become available in the field of hypertension since the JNC report of 1988. The JNC V report has changed the categorization of blood pressure, modified suggested drugs for initial therapy, and recommended that diuretics or beta blockers be considered the first-line drugs of choice. Information concerning the J curve and end-stage renal disease has made therapeutic goals more challenging. One of the most important additions to this report is the new information on treating elderly patients, which had been lacking until last year. The report calls on pharmacists to assist with detecting, evaluating, and referring hypertensive patients. Pharmacists must take a leadership role in promoting compliance with antihypertensive therapy and can assist other health-care professionals by suggesting therapeutic alternatives to improve efficacy, reduce the frequency of administration, and lower costs. The complete JNC V report is an essential reference for the files of any pharmacist who is responsible for the care of hypertensive patients.     

Impact of MR imaging on nationwide health care costs and comparison with other imaging procedures

OBJECTIVE: We wished to determine the extent to which MR imaging contributes to the overall costs of imaging in the United States and to compare MR imaging costs with other imaging techniques. MATERIALS AND METHODS: All 23 current procedural terminology, version 4 (CPT-4) codes for MR imaging were extracted from the national 1993 Part B Medicare annual data reimbursement file. For each code, we calculated total Medicare physician reimbursements. Aggregate reimbursement for all MR imaging was compared with aggregate reimbursement for all 659 imaging-related current procedural terminology, version 4 codes and also with comparable figures for echocardiography and other categories of cardiovascular imaging. RESULTS: Within the 23 MR imaging codes, 1,449,911 examinations were performed on Medicare patients in 1993, for which physicians were reimbursed $370 million. Medicare reimbursement of physicians for all 659 imaging-related procedures was $5.3 billion. Thus, MR imaging accounted for only 7% of all imaging costs. By comparison, a group of just 10 imaging codes, which are primarily cardiovascular in nature, accounted for $1.67 billion, or 32% of the entire Part B costs for imaging. Reimbursements for echocardiography alone are more than twice those for MR imaging. CONCLUSION: From the national perspective, MR imaging does not appear to warrant its reputation as a costly procedure. The costs of echocardiography and other imaging related to the cardiovascular system are considerably higher.     

Caenorhabditis elegans EGL-1 disrupts the interaction of CED-9 with CED-4 and promotes CED-3 activation

In the nematode Caenorhabditis elegans, programmed cell death is implemented by the protease CED-3 whose activity is inhibited by CED-9 through physical associations with the regulator CED-4. The product of a recently described gene, egl-1, binds to and inhibits CED-9. In the present studies, we have addressed the molecular mechanism by which EGL-1 regulates CED-9 function and promotes cell death. Expression of CED-4 and CED-3 resulted in decreased survival and apoptosis of mammalian cells, activities that could be inhibited by CED-9. Importantly, this protective effect of CED-9 was antagonized by EGL-1. Immunoprecipitation analysis showed that EGL-1 binding to CED-9 disrupts the association between CED-4 and CED-9, an activity that required the BH3 motif of EGL-1. Consistent with these results, expression of EGL-1 promoted CED-4-dependent processing of CED-3, and this activity of EGL-1 was mediated through inhibition of CED-9. In mammalian cells, CED-9 is known to target the subcellular localization of CED-4 from the cytosol to intracellular membranes. Expression of EGL-1 resulted in redistribution of CED-4 from intracellular membranes, where it co-localized with CED-9, to the cytoplasm, providing further evidence that EGL-1 regulates CED-4 through CED-9. Finally, the levels of EGL-1 were greatly enhanced by co-expression of CED-9 in both mammalian cells and in a cell-free system, suggesting a role for CED-9 in the expression and/or stabilization of EGL-1. These studies provide a mechanism for how EGL-1 functions to antagonize pro-survival of CED-9 and to promote CED-3 activation and programmed cell death.     

Structural characteristics of modified activated carbons and adsorption of explosives

Several series of activated carbons prepared by catalytic and noncatalytic gasification and subsequent deposition of pyrocarbon by pyrolysis of methylene chloride or n-amyl alcohol were studied by FTIR, chromatography, and adsorption methods using nitrogen and probe organics (explosives). The relationships between the textural characteristics of carbon samples and the recovery rates (eta) of explosives on solid-phase extraction (SPE) using different solvents for their elution after adsorption were analyzed using experimental and quantum chemical calculation results. The eta values for nitrate esters, cyclic nitroamines, and nitroaromatics only partially correlate with different adsorbent parameters (characterizing microporosity, mesoporosity, pore size distributions, etc.), polarity of eluting solvents, or characteristics of probe molecules, since there are many factors strongly affecting the recovery rates. Some of the synthesized carbons provide higher eta values than those for such commercial adsorbents as Hypercarb and Envicarb.     

Pharmacokinetics and metabolism of [14C]dichloroacetate in male Sprague-Dawley rats. Identification of glycine conjugates, including hippurate, as urinary metabolites of dichloroacetate

We have recently isolated a mammary growth factor from the conditioned medium of mouse mammary stromal fibroblasts and identified it as a mouse homologue of human HGF (hepatocyte growth factor). To elucidate the role of HGF in mouse mammary tumorigenesis, we produced recombinant mouse HGF and examined its effects on primary cultures of mouse mammary tumor cells in this study. HGF at concentrations above 20 ng/ml maximally stimulated the growth of mammary tumor cells in primary monolayer culture. HGF also stimulated the three-dimensional growth and branching morphogenesis of mammary tumor cells cultured inside collagen gels. A comparison of the growth-stimulating activity of HGF with that of EGF (epidermal growth factor) and KGF (keratinocyte growth factor) revealed that HGF is the most potent growth factor among the three. Immunological studies using an antibody against mouse HGF demonstrated that 74% of the growth-stimulating activity present in the mammary fibroblast-conditioned medium was abolished by the antibody, indicating that HGF is the major growth factor produced by the fibroblasts. These observations thus suggest a role for HGF as a mammary stromal fibroblast-derived factor which stimulates growth and morphogenesis of adjacent mammary tumor cells in vivo.     

Effect of small doses of pituitrin on electrocardiography of ischemia in the experiment

A new type of reaction to the myocardial ischemia was established in chronic experiments in conscious dogs. It consists in some changes of local myocardial activity and, consequently, in constant or transient normalization of ECG. Pharmacological stabilization of this process augments myocardial resistance to ischemia 40-50 times and more. The role of small doses of pituitrin in this reaction was established.