Evidence for involvement of TNF-alpha in the induction phase and IFN-beta in the effector phase of antiproliferative activity of splenic macrophages.

Splenic macrophages play a key role in regulating cell proliferation during a variety of chronic perturbations of the hematopoietic system. This regulatory activity is in sharp contrast to the activities of inflammatory monocytes/macrophages in that it is not dominated by the secretion of prostaglandins or toxic metabolites such as peroxides. A productive model for studying these nontoxic regulatory activities of splenic macrophages has been provided by macrophages generated in vitro (M phi-c) during autologous spleen cell culture.

Distinguishing sympathomimetic amines from amphetamine and methamphetamine in urine by gas chromatography/mass spectrometry.

Derivatives of seven commonly used sympathomimetic amines and two "designer amines" were isolated from urine, separated chromatographically from amphetamine and methamphetamine, and determined by mass spectrometry with selected ion monitoring. The drugs included ephedrine, propylhexedrine, pseudoephedrine, phenylpropanolamine, hydroxynorephedrine, phenylephrine, phentermine, methylenedioxyamphetamine (MDA), and methylenedioxy methamphetamine (MDMA). The drugs were liquid extracted from urine and derivatized by either heptafluorobutyric anhydride (HFBA) or 4-carbethoxyhexafluorobutyryl chloride (4-CB).

Induction of immune tolerance in patients with hemophilia A and inhibitors.

Infusions of factor VIII at 50-100 U/kg were administered "on demand" for bleeding episodes, or once weekly, in eight patients (aged 3-20 years) with hemophilia A and historically high titer inhibitors to factor VIII. Inhibitors were eliminated and immunologic tolerance to factor VIII occurred in five of the eight patients within 5-31 months. Four patients had minimal anamnestic responses upon starting factor VIII infusions.

The relationship between craving, anxiety, and other symptoms in opioid withdrawal.

Craving and anxiety share many similar attributes including comparable responses to pharmacological agents. To better characterize the relationship among craving, anxiety, and other opioid withdrawal signs and symptoms, we examined 32 opioid-dependent subjects undergoing clonidine-assisted opioid withdrawal. A 13-item analog scale measured subjective withdrawal symptoms.

The development of a programme of care for elderly people in Northern Ireland.

This paper describes the development of a Programme of Care for elderly people in Northern Ireland. The problems of the elderly were previously identified, and a classification system was designed in key areas which allocated groups of individuals with similar needs to particular services. It was thus possible to quantify the resources required to meet the future needs of elderly people in Northern Ireland.

Effectiveness of three types of spouse-involved behavioral alcoholism treatment.

Treatment was provided to 45 alcoholics and their spouses in one of three out-patient behavioral treatment conditions: (1) minimal spouse involvement (MSI) (n = 14), (2) alcohol-focused spouse involvement (AFSI) (n = 12), or (3) alcohol-focused spouse involvement plus behavioral marital therapy (ABMT) (n = 19). Subjects were followed for 18 months after treatment. Subjects in all conditions reported significant decreases in frequency of drinking and frequency of heavy drinking, and reported increased life satisfaction.

Sensitive, colorimetric enzyme amplification cascade for determination of alkaline phosphatase and application of the method to an immunoassay of thyrotropin.

A highly sensitive flavin adenine dinucleotide-3'-phosphate (FADP)-based enzyme amplification cascade has been developed for determining alkaline phosphatase (ALP; EC 3.1.3.

Intensive therapy for small-cell lung cancer using carboplatin alternating with cisplatin, ifosfamide, etoposide, mid-cycle vincristine, and radiotherapy.

Forty patients with small-cell lung cancer (31 patients with limited-stage [LS] disease, and nine patients with extensive-stage [ES] disease but of good performance status) have been treated with an intensive therapy composed of carboplatin alternating with cisplatin, ifosfamide, and etoposide with vincristine on day 14 of each carboplatin cycle. A maximum of six cycles were administered at 3 weekly intervals after the cisplatin combination and 4 weekly after the carboplatin combination. Prophylactic cranial irradiation was given with the first cycle of chemotherapy and thoracic irradiation with the third cycle.

Seasonal variations in fibrinogen concentrations among elderly people.

Mortality and morbidity in elderly people are higher in winter than in summer months, with seasonal variations in rates of both fatal and non-fatal myocardial infarction and stroke. To identify factors that might contribute to the excess winter frequency of cardiovascular disease in the elderly, we studied 100 subjects aged 75 and over who lived in either their own homes or in sheltered or residential accommodation. Each person was visited each month for one year, body and environmental temperatures were noted, and cardiovascular risk factors were measured.

Separation and purification of oligonucleotides using a new bonded-phase packing material.

We describe a new bonded-phase packing material, based upon surface-stabilised microparticulate silica, suitable for the rapid separation and purification of oligonucleotides. Columns packed with this material were demonstrated to give rapid separations of individual oligonucleotide species of up to 44 base units with high purity; agarose gel electrophoresis showed that the products were essentially single bands, with only trace quantities of the (n-1)-mer present. Baseline resolution of the desired oligomer from (n +/- 1)-mer was achieved under preparative loading conditions, where up to 200-300 micrograms of oligonucleotide could be separated.

The effects of acute moderate exercise on leukocyte and lymphocyte subpopulations.

The extent and duration of changes in circulating leukocyte and lymphocyte subpopulations, cortisol, and catecholamines were examined in 12 women who walked 45 min at 60% VO2max in a laboratory setting. A two-factor, 2 x 6 design with repeated measures on both factors was utilized. The first factor was condition (exercise and rest), and the second factor was time (six points of measurement over a 24-h period), with treatment order counterbalanced.

A comparison of single-dose versus conventional-dose antibiotic treatment of bacteriuria in elderly women.

The efficacy of single-dose antibiotic therapy for the treatment of bacteriuria in a group of non-catheterized elderly women was compared with that of conventional 7-10 day courses of antibiotic therapy. Thirty-one women received single-dose treatment and 22 conventional-dose treatment. The cure rates at 1 and 6 weeks for the single-dose treatments were 52% and 38%, respectively, and the cure rates for the conventional-dose treatments at 1 and 6 weeks were 59% and 52%, respectively.

Insulin as a mitogenic factor: role in the pathogenesis of cardiovascular disease.

Evidence has been accumulating that insulin has actions that may promote the development of atherosclerosis. Research has involved three broad areas: actions of insulin on cultured arterial cells, the effect of insulin on isolated artery preparations, and the development of lipid-containing lesions in the arteries of experimental animals. Insulin, in concentrations similar to those found in physiologic conditions, stimulates proliferation of cultured arterial smooth muscle cells from a number of species, including humans.

Functional decline and survival in dependent elderly people.

A survey of dependency levels was carried out in 1985 and 1989 in 41 residents of old peoples homes and 25 patients in geriatric continuing care wards. There was an increase in all levels of dependency for those in both types of care. In the hospital patients surveyed in 1985, mortality was greatest in the most dependent, particularly those with impaired mental function.

Intraluminal irradiation for the palliation of lung cancer with the high dose rate micro-Selectron.

Fifty patients with inoperable, symptomatic endobronchial carcinoma were treated by a single exposure of intraluminal radiotherapy. A high dose rate afterloading system (the micro-Selectron-HDR) was used to minimise radiation exposure for staff. Haemoptysis was relieved in 24 of 28 patients, breathlessness in 21 of 33 patients, and cough in nine of 18 patients.

The impact of private residential and nursing care on statutory residential and hospital care of elderly people in south Belfast.

Dependency levels were compared in residents of private, voluntary and statutory residential homes, private nursing homes and patients in geriatric continuing-care wards in South Belfast. Dependency levels were least in private and voluntary residential homes, were similar in residential and private nursing homes, but were very much greater in the geriatric wards. Evidence of dementia was found in 23% of residents of voluntary homes, 35% of residents of private residential homes, 61% of residents of statutory residential homes, 54% of those in private nursing homes and 80% of patients in geriatric wards.

Insulin and atheroma. 20-yr perspective.

Many clinical studies have shown an increased insulin response to oral glucose in patients with ischemia of the heart, lower limbs, or brain. Hyperinsulinemia also occurs in patients with angiographically proved atherosclerosis without ischemia and thus appears to be related to arterial disease and not to be a nonspecific response to tissue injury. Fasting insulin levels and insulin responses to intravenous stimuli, including glucose, tolbutamide, and arginine, are normal, suggesting a gastrointestinal factor may be involved in the increased insulin response to oral glucose.

Renal effects of ibuprofen, piroxicam, and sulindac in patients with asymptomatic renal failure. A prospective, randomized, crossover comparison.

Study Objective: To evaluate the effects of three chemically distinct nonsteroidal anti-inflammatory drugs (NSAIDs) on renal function in patients with asymptomatic, mild but stable chronic renal failure.

Design: Prospectively randomized, triple-crossover study with at least 1-month washout between each of three treatment periods.

Setting: Inpatient and outpatient clinical research center of a university teaching hospital.

Identification of the needs of elderly people in Northern Ireland.

This paper presents the results of a survey on persons over the age of 65 in Northern Ireland. One of the aims of this research was to identify and measure the needs of the elderly population in order to develop a Programme of Care. It would seem logical that the problems of the elderly tend to increase with age.

Ifosfamide, doxorubicin and etoposide in small cell lung cancer patients with poor prognosis.

61 patients with small cell lung cancer in a poor prognosis group were treated with chemotherapy and with thoracic radiotherapy if they had 'limited stage' disease. No prophylactic cranial irradiation was given. Chemotherapy comprised doxorubicin 50 mg/m2 and ifosfamide 5 g/m2 with mesna on day 1, and etoposide 120 mg/m2 intravenously on days 1 and 2 and 240 mg/m2 orally on day 3.