Prevention of iron deficiency with carbonyl iron in female blood donors.

The effectiveness of elemental, nontoxic carbonyl iron in replacing iron lost at blood donation was examined. In a randomized double-blind design, 99 women, aged 18 to 40, were given placebo or low-dose carbonyl iron (100 mg orally) at bedtime for 56 days after phlebotomy. Compliance was equivalent for the two regimens.

Absence of a binding reactivity of human C-reactive protein for immunoglobulin or immune complexes.

Because C-reactive protein (CRP) has been identified as a component of circulating immune complexes from patients with inflammatory diseases, we sought to evaluate a potentially clinically important interaction of this acute-phase protein with immunoglobulin or experimentally-prepared immune complexes in vitro. Highly purified human CRP was incubated with a variety of immunoglobulin substrates, including monomeric immunoglobulin G1 (IgG1), a polyclonal IgG, heat-aggregated IgG, and human serum albumin/anti-serum albumin complexes. We were unable to detect a significant binding interaction of radioiodinated CRP with any of these materials, using either polyethylene glycol (PEG) precipitation or sucrose density gradient ultracentrifugation.

The effects of thrombin on bovine aortic endothelial and smooth muscle cells.

Recent evidence suggests that thrombin interacts with various cell types, stimulating cellular proliferation and protein and prostanoid production. To further delineate its role in vascular healing, we have studied the effects of thrombin on proliferation and matrix production by the cells of the vessel wall. The addition of thrombin (1 unit/ml) to cultures of bovine aortic smooth muscle cells resulted in an increase in cell proliferation (p less than 0.

Neutrophil adhesion in the elderly: inhibitory effects of plasma from elderly patients.

Neutrophil (PMN) adherence is a critical component of host defense against infection. We questioned whether abnormalities of PMN adherence may be responsible, in part, for the increased susceptibility to infection in the elderly. We examined the adherence of 51Cr-labeled PMN from 18 elderly (65-95 years) and 18 younger subjects (18-40 years) to gelatin-coated plastic (gel) and bovine aortic endothelial monolayers (BAEC).

Diagnosis and treatment of the retropharyngeal abscess in adults.

While the retropharyngeal space abscess is an extremely rare entity that may arise from odontogenic infections, its potential complications may be fatal. When infection of the retropharyngeal space occurs, urgent surgical and antibiotic therapy is required. A review of the anatomy, symptoms, treatment, diagnostic methods and complications is provided.

24,25,28-trihydroxyvitamin D2 and 24,25,26-trihydroxyvitamin D2: novel metabolites of vitamin D2.

Understanding of the inactivation pathways of 25-hydroxyvitamin D2 and 24-hydroxyvitamin D2, the two physiologically significant monohydroxylated metabolites of vitamin D2, is of importance, especially during hypervitaminosis D2. In a recent study, it has been demonstrated that the inactivation of 24-hydroxyvitamin D2 occurs through its conversion into 24,26-dihydroxyvitamin D2 [Koszewski, N.J.

Total body water measurement in normal and diabetic pregnancy: evidence for maternal and amniotic fluid equilibrium.

The H2[18O] tracer dilution method was applied to quantify total body water in 6 normal nonpregnant women, 8 normal pregnant women (gestation 29.3 +/- 6.0 weeks, range 21-37 weeks), and 8 insulin-dependent diabetic pregnant subjects (gestation 29.

Left ventricular filling shortly after an uncomplicated myocardial infarction as a predictor of subsequent exercise capacity.

Resting measurements of left ventricular systolic function do not reliably predict exercise capacity in patients with cardiac disease. Therefore left ventricular filling shortly after a myocardial infarction was prospectively studied to determine whether it could predict subsequent exercise time. Consecutive patients with an acute infarction underwent Doppler and two-dimensional echocardiography within 36 hours of infarction.

Hepatic mitochondrial malondialdehyde metabolism in rats with chronic iron overload.

Peroxidative decomposition of mitochondrial membrane phospholipids with subsequent mitochondrial dysfunction is a postulated mechanism of liver cell injury in parenchymal iron overload. Malondialdehyde is formed when polyunsaturated fatty acids of membrane phospholipids undergo peroxidative decomposition, and it is metabolized by aldehyde dehydrogenase. We studied mitochondrial metabolism of malondialdehyde in rats with chronic dietary iron overload.

Ethical issues in human genetic technology.

The United States and several nations in the developed world have initiated efforts to map and sequence the human genome. The knowledge derived from these efforts will have a profound influence on the practice of medicine. This article reviews the technical developments in the field of human genetics and reviews the ethical issues relevant to the pediatrician in the application of this technology in prenatal screening, presymptomatic screening, carrier screening, and gene therapy.

Renal and hemodynamic effects of atrial natriuretic peptide in patients with cirrhosis.

The effects of anaritide, a 25-amino-acid synthetic analogue of ANP, were evaluated in 28 patients with cirrhosis complicated by ascites and/or edema. Each patient received two doses of the agent, as well as an infusion of placebo. Six different doses were tested ranging from 0.

The erosion of physician-patient privilege and patient confidentiality.

With the proliferation of third party payers for health care who exercise utilization management, there has been an erosion of the physician-patient privilege and patient confidentiality. The kinds of medical information obtained by third party payers under the guise of claims administration violate the spirit if not the actual laws pertaining to physician-patient communication. It presents three episodes involving the first author in which that communication was violated by third parties administering health care benefits.

Rapid detection of respiratory syncytial virus by a biotin-enhanced immunoassay: test performance by laboratory technologists and housestaff.

A biotin-enhanced enzyme immunoassay (EIA) for respiratory syncytial virus (RSV) antigen detection (TESTPACK RSV) was prospectively compared with virus isolation in cell culture and immunofluorescence. Of 156 nasopharyngeal swab specimens from infants with respiratory symptoms, 81 (52%) yielded RSV in culture. Compared with culture the sensitivity of the EIA was 95% and specificity was 92%; the specificity increased to 97% with a blocking assay.

Thoracic stimulation and prolactin secretion.

Although galactorrhea and/or enhanced prolactin (PRL) secretion have been reported with a variety of thoracic stimuli, the effect of thoracic stimulation on dynamic prolactin secretion is not clear. A 49-year-old woman with ventilatory muscle weakness from polio presented with galactorrhea, and intermittent hyperprolactinemia but regular menses. The galactorrhea was noted following the use of a new, tight fitting cuirass (thoracic apparatus which assists ventilation).

Use of three-dimensional computerized tomography in the diagnosis of an obstructed coronoid process.

The principles of three-dimensional computerized tomography are discussed. An unusual case of an iatrogenically induced coronoid obstruction is presented with the three-dimensional computerized tomograph as an integral tool in its diagnosis.

Evidence for the presence of a benzodiazepine receptor binding substance in cerebrospinal fluid of a rabbit model of hepatic encephalopathy.

Based on the reversal of hepatic encephalopathy in animal models with administration of specific benzodiazepine receptor antagonists, it has been postulated that this syndrome may be mediated by an endogenous benzodiazepine-like compound. In this study using a radio-receptor assay, evidence for the existence of this substance has been demonstrated in cerebrospinal fluid but not sera of rabbits with hepatic encephalopathy due to galactosamine-induced hepature failure. Cerebrospinal fluid from rabbits with hepatic encephalopathy caused 36.

Morphologic and histologic changes in canine temporomandibular joint tissues following arthroscopic guided neodymium:YAG laser exposure.

A neodymium:yttrium aluminum garnet (Nd:YAG) laser beam was introduced by a quartz fiber passed arthroscopically into the superior joint space of the temporomandibular joints (TMJ) of five mongrel dogs, with one joint serving as a control without laser wounds. Immediate postoperative death and examination of the disc grossly and histologically revealed different patterns for contact and noncontact burn wounds. The wounds exhibited signs of thermal coagulation necrosis similar to those reported in other tissues.

Transient maternal hypotension following epidural anesthesia.

Transient maternal hypotension following regional anesthesia can lead to significantly lower umbilical cord pH values. Although this acidosis has not been found to be clinically significant, acidosis may increase the placental transfer of local anesthetic agents as a result of "ion trapping." The purpose of this study was to examine the pharmacologic and clinical consequences of transient maternal hypotension following epidural anesthesia with 0.

Management of low-caliber, low-velocity gunshot wounds of the maxillofacial region.

Low-velocity, low-caliber missile wounds have a wounding profile different from that of high-velocity, high-caliber missiles. The pathophysiology of these types of injuries is discussed. Care for such injuries should be conservative.

Meconium aspiration syndrome: intrapartum and neonatal attributes.

To identify the fetus and newborn at risk for meconium aspiration syndrome the perinatal characteristics of 238 infants delivered through meconium-stained amniotic fluid were prospectively examined. All infants with meconium-stained amniotic fluid were routinely suctioned with a DeLee apparatus before tracheal intubation and suctioning. The type and presence of meconium in the trachea, neonatal breathing before intubation, and Apgar scores were recorded in the delivery room.

The infected prosthetic total temporomandibular joint replacement: report of two cases.

Two cases of infected total temporomandibular joint replacements are reported. The WBC count, erythrocyte sedimentation rate, and temperature were within normal limits, but erythema, edema, and pain provided the initial clue to the infection. Ultrasonography ultimately revealed a fluid collection and allowed aspiration of the fluid-filled cavity, providing a diagnosis and directing antibiotic therapy.

Carotid endarterectomy.

Study Objective: To evaluate the usefulness of doing carotid endarterectomy in patients with symptomatic or asymptomatic carotid artery disease.

Design: Synthesis and summarization of data on the untreated course of cerebrovascular disease, and review of selected evidence and expert opinion on the risks and benefits of endarterectomy and medical therapy.

Main Results: There is a large body of data related to the untreated course of cerebrovascular disease, the efficacy of aspirin in patients with transient ischemic attacks, and the comparative responsiveness to surgery of symptomatic patients with different presentations.

The role of pre-resectional laser recanalization for obstructing carcinomas of the colon and rectum.

The Nd:YAG laser has proved its efficacy for recanalizing obstructing lesions throughout the gastrointestinal tract. In a preliminary report using the Nd:YAG laser as a pre-resectional treatment for functionally obstructing colorectal carcinoma we showed that this modality accomplished good decompression, allowing for formal bowel preparation, a definitive one-stage operation with no increased mortality or morbidity, and that the use of the Nd:YAG laser was significantly cost-effective. Our cumulative experience from 1985 to 1988 includes 11 patients; nine underwent pre-resection laser therapy followed by primary resection and anastomosis, and two underwent abdominoperineal resection.