Heart rate variability and sudden death secondary to coronary artery disease during ambulatory electrocardiographic monitoring.

Data are analyzed from 5 patients who died suddenly during ambulatory electrocardiographic monitoring. Three of the patients were also assessed in terms of 2 recently developed indexes of heart rate (HR) variability. One of these, the standard deviation of RR intervals during successive 5-minute segments averaged over 24 hours, has been reported to be a putative index of vagal tone.

Increased delivery of tumor-specific monoclonal antibodies to brain after osmotic blood-brain barrier modification in patients with melanoma metastatic to the central nervous system.

We evaluated the delivery of melanoma-specific radiolabeled monoclonal antibody (MAb) Fab fragments in a pilot study of three patients with melanoma metastatic to the central nervous system. Tumor samples demonstrated excellent immunohistochemical reactivity with Fab 96.5, specific for a 97,000-molecular-weight melanoma antigen (p97), or Fab 48.

Estimating profits in a capitation program. Planning for cost.

This article is designed to help dentists make better decisions regarding capitation programs. It focuses on approaches to costs that can be useful. An example is given that illustrates how these cost concepts might be used to analyze a capitation proposal.

Clinical confirmation of organophosphate poisoning by serial cholinesterase analyses.

Three groups of agricultural workers with a history of exposure to organophosphate pesticides were followed up to evaluate the utility of sequential postexposure cholinesterase analyses to confirm organophosphate intoxication in the absence of baseline cholinesterase values. Three or more cholinergic symptoms were reported by 50 of the 72 patients. Initial plasma and red blood cell cholinesterase values of 45 of the workers were above the lower limit of the laboratory normal range.

Early vitreous changes in experimental proliferative vitreoretinopathy.

Proton magnetic resonance imaging (MRI) was employed to obtain information on early vitreal changes preceding ophthalmoscopically visible proliferative vitreoretinopathy. Rabbits were injected close to the posterior pole with a suspension of 250 000 cultured homologous fibroblasts. The MRI was carried out using a 1.

MR imaging of enucleated human eyes at 1.4 tesla.

Proton magnetic resonance images obtained for nine human eyes with various pathology were correlated with histological findings. One eye with retinal gliosis, three eyes with malignant melanoma, one eye with extraocular squamous cell carcinoma, one pair of eyes with incipient senile cataracts, and one pair of eyes with diabetic cataracts were examined at a field strength of 1.4 T using spin-echo and inversion-recovery signal acquisition protocols.

Osmotic blood-brain barrier opening to IgM monoclonal antibody in the rat.

Pharmacokinetic parameters of iodinated monoclonal antibody (MAb) delivery to normal rat brain were examined. The mean cerebrovascular permeability-surface area (PA; permeability X capillary surface area) to immunoglobulin M (IgM) MAb (mol wt 1,000,000) 10 min after infusion was 0.40 X 10(-6) S-1.

The effect of oxidation on sorbitol pathway kinetics.

The rapid conversion of glucose to sorbitol by aldose reductase and the consequent hyperosmolarity of the cytoplasm has been shown to be the primary cause of the so-called "sugar" or "osmotic" cataract in many animal lenses. It is not as clear, however, that hyperosmolarity is the principal factor in the etiology of cataracts in human diabetic subjects. In fact, the comparatively low activity of aldose reductase in the human lens as compared with several animal lenses, and the osmotically insignificant levels of sorbitol pathway products (sorbitol and fructose), suggest that hyperosmolarity, per se, may not be as important a factor in human cataract formation as it is in animals.

Historical background: patellofemoral pain in young people.

This article examines the evolution of the current understanding of what patellofemoral pain is, or is not, in young people. It focuses on the articular cartilage of the patella because chondromalacia patellae (softened articular cartilage) was almost unanimously presumed to be the primary cause of patellofemoral pain in young people until recently.

Clinical confirmation of organophosphate poisoning of agricultural workers.

A group of 31 lettuce harvesters exposed to the organophosphate pesticide mevinphos presented to a local emergency room with moderate cholinergic symptoms and eye and skin irritation, with 22 of the subjects (76%) reporting three or more symptoms. None had baseline cholinesterase values, and plasma cholinesterase activity for all but two workers was above the lower limit of the laboratory normal range. None of the workers received antidotes and all were released for return to work.

A comparative distribution study of 111In-labeled DTPA and TTHA monoclonal antibody conjugates in a choriocarcinoma xenograft model.

Conjugates of the chelating agents DTPA and TTHA with a monoclonal anti-HCG were prepared. The tissue distribution of the 111In-labeled conjugates and also 111In-citrate was studied in mice bearing human choriocarcinoma xenografts. The antibody conjugates both gave high liver and spleen radionuclide accumulation.

Osmotic blood-brain barrier modification: monoclonal antibody, albumin, and methotrexate delivery to cerebrospinal fluid and brain.

In the dog, osmotic opening of the blood-brain barrier (BBB) in the posterior circulation via the vertebral artery and in the anterior circulation via the internal carotid artery was utilized to increase the delivery of three substances of varying molecular weight to the central nervous system. The cerebrospinal fluid (CSF) concentration of all three agents dramatically increased after BBB opening. In contrast to methotrexate, Evans blue-albumin and monoclonal antibody (MAb) concentrations in CSF were 6-fold greater when given after posterior rather than anterior circulation BBB opening.

Growth of human lung tumor in the brain of the nude rat as a model to evaluate antitumor agent delivery across the blood-brain barrier.

We have developed a brain tumor model in the nude rat utilizing NCI-N417D human small cell carcinoma of the lung grown both intracerebrally and s.c. The median latency period from the time of intracerebral tumor inoculation to the onset of neurological symptoms is 13 days with an intracerebral tumor take rate of 91% (29 of 32).

Clinical management of field worker organophosphate poisoning.

A group of 16 cauliflower workers poisoned by residues of the organophosphate insecticides mevinphos and phosphamidon was followed in weekly clinics with interviews and determinations of plasma and erythrocyte cholinesterase levels. None had preexposure baseline values. Although six had initial erythrocyte cholinesterase values within the laboratory normal range, subsequent testing showed their erythrocyte activity had been significantly inhibited.

Sorbitol/fructose metabolism in the lens.

The function of the sorbitol pathway, both as a secondary energy source and as an osmotic counterbalancing force, was examined. Rat lenses were incubated in media containing fructose as the primary exogenous energy source, and 31P nuclear magnetic resonance (NMR) spectra were accumulated. Fructose was found to be a sub-optimal but usable substrate for glycolysis.

Effects of potassium on sodium balance, renin, noradrenaline and arterial pressure.

To determine the effects of potassium on blood pressure and factors affecting blood pressure, we conducted a randomized, placebo controlled trial of a potassium chloride-based substitute for table salt in 23 patients with mild to moderate essential hypertension. In addition, the effects of potassium chloride on sodium balance were studied in 10 normal subjects. Potassium loading with 100 mmol/day over five days in these normal subjects caused a cumulative negative sodium balance of 138 +/- 35 mmol, similar in degree to that achieved by severe dietary sodium restriction.

True hermaphroditism. A case report with observations on its bizarre presentation.

A true XX hermaphrodite presenting in adulthood with male sex gender identity was found to have separate vaginal and urethral openings in the perineum. A total vaginectomy was performed at the same time as total abdominal hysterectomy and gonadectomy because the vaginal opening would interfere with a urethroplasty to repair the hypospadias and chordee phallus. During this procedure prostatic tissue was excised in the area of the anterior vaginal wall adjacent to the urethra.

Altered phosphate metabolism in the intact rabbit lens under high glucose conditions and its prevention by an aldose reductase inhibitor.

Intact paired rabbit lenses were incubated in media containing 5.5 mM and 35.5 mM glucose (both at 290 +/- 3 mOsm) and examined by phosphorus-31 nuclear magnetic resonance spectroscopy.

Acyclovir in cytomegalovirus infection 3 1/2 years after renal transplantation. An unusual case and dramatic response.

Late cytomegalovirus (CMV) infection in renal allograft recipients is uncommon. The treatment of CMV infection is controversial, with numerous claims of successful treatment with different drugs. We report the successful use of acyclovir in a serious case of CMV infection occurring in a young woman 3 1/2 years after a renal transplant.

The differentiation of foot and mouth disease virus strains using an indirect sandwich enzyme-linked immunosorbent assay saturation model.

Sigmoid saturation curves were fitted to the results of titrations of antiserum to foot and mouth disease virus against homologous and heterologous virus strains. Differentiation of strains was readily evident from the different levels of the homologous and heterologous curves. These differences could be quantified by comparison of the saturation curve parameters K and PRmax.