Determination of water permeability coefficient for human spermatozoa and its activation energy.

Four experiments were conducted to determine the permeability coefficient of human sperm to water (Lp) and its activation energy (Ea). Critical tonicity (tonicity at which 50% of the cells swell and lyse) was determined by equilibrating sperm to 22 degrees C (experiments 1a and 1b), 30, 22, 8, or 0 degrees C (experiment 2a), and 0, -1, -3, -5, or -7 degrees C (experiment 2b) and then exposing them to various hypotonic media (215-3 mOsm). For Lp determination, sperm were equilibrated to 30, 22, 8, or 0 degrees C (experiment 3a), 8, 0, or -3 degrees C (experiment 3b), and -1, -3, -5, or -7 degrees C (experiment 3c), and then were exposed for increasing times to hypotonic (40 mOsm) media.

Severe hypoxia related to uncomplicated atrial septal defect.

A 73-year-old man was admitted to our institution with severe hypoxia. Cardiac catheterization and transesophageal echocardiography revealed an atrial septal defect with an interatrial right-to-left shunt but with no pulmonary hypertension. Direct examination at surgery revealed an elongated thoracic aorta that caused the aortic annulus to reside at the level of the diaphragm and the heart to be positioned transversely in the mediastinum.

Immunological studies of lactoferrin in human placentae.

Lactoferrin (LF) and transferrin (Trf) are glycoproteins with strong affinities for ferric ions. Human syncytiotrophoblastic membranes analyzed by enzyme linked immunosorbent assay (ELISA) and immunoblotting were negative with monoclonal and polyclonal antibodies to LF. Immunohistological studies of 35 normal placentae showed that LF was absent from the trophoblast basement membranes, stroma and fetal stem vessel endothelium, but positive cells were occasionally noted in intervillous spaces and fetal stem vessels.

Expression of CD59, a human complement system regulatory protein, in extraembryonic membranes.

CD59 (leukocyte cluster of differentiation antigen 59), is a phosphatidylinositol glycan-anchored membrane protein that inhibits lysis of cells by terminal complement system components. To further define complement regulatory proteins relevant to pregnancy, this study characterized the expression of CD59 in human extraembryonic membranes. Immunohistology with CD59 monoclonal antibody MEM-43 showed that this molecule was normally present on the apical surface of the syncytiotrophoblast, on extravillous cytotrophoblast, and amniotic epithelium.

Glycerol permeability of human spermatozoa and its activation energy.

Glycerol has commonly been employed as a cryoprotectant in cryopreservation of human spermatozoa. However, the addition of glycerol into the sperm before freezing and the removal of glycerol from the sperm after freezing and thawing result in anisotonic environments to the cells, which can cause cell injury. To define optimal procedures for the addition/removal of glycerol and to minimize the cell injury, one needs to know the kinetics of glycerol permeation across the sperm plasma membrane at different temperatures.

Vascular immunopathology and atheroma development in human allografted organs.

Human atherosclerosis requires decades to develop spontaneously, and its development customarily is not monitored by serial biopsies. Atherosclerosis in allografts develops within months, and biopsy specimens are usually obtained from the grafts. We have used immunocytochemical techniques to study biopsy specimens of cardiac and renal allografts for parameters of vascular changes.

Novel immunohistochemical markers of human renal allograft dysfunction--antithrombin III, Thy-1, urokinase, and alpha-smooth muscle actin.

We have studied the expression of alpha-smooth muscle actin (alpha sm-1) by mesangial cells, and the expression of Thy-1 glycoprotein, antithrombin III (ATIII), and urokinase by tubular epithelial cells in normal kidneys and dysfunctional renal allografts. Kidney biopsies were studied immunocytochemically for changes in each of these markers and the findings were classified into two groups and compared with creatinine plasma levels at the time the biopsies were taken. In dysfunctional grafts, mesangial alpha sm-1 and tubular epithelial Thy-1 reactivities were greatly diminished, and urokinase and ATIII were missing from proximal renal tubular epithelial cells.

Changes in serum catecholamine levels in patients who are brain dead.

Prospective blood samplings from 15 patients admitted with a Glasgow Coma Score of less than 7 were obtained to observe and compare epinephrine, norepinephrine, and dopamine serum levels in patients with brain injury before, after, and in the absence of brain death. Nine of the patients developed or were admitted after brain death. Wide variations in catecholamine blood levels over time were documented, and subgroup analysis precluded useful statistical comparison or inference of the data.

Wound evaluation and cleansing.

The approach to wound management in the Emergency Department does not differ from that used in evaluating other complaints. This consists of a problem-directed history and physical examination. The history should probe for host and wound factors that increase the risk of a poor outcome.

Comparison of a new pressurized saline canister versus syringe irrigation for laceration cleansing in the emergency department.

Study Objective: Studies have documented the efficacy of normal saline irrigation in decreasing wound infection rates. Wounds traditionally are irrigated using a syringe and needle with manual injection of fluid, a time- and labor-intensive method. We compared irrigation times and infection rates for wounds cleansed with syringe irrigation versus a new, single-use canister of pressurized (8 psi) sterile normal saline.

Intraoperative ultrasound of hepatic tumors.

Intraoperative ultrasound (IOUS) scanning of liver masses was compared with those of preoperative computed tomography (CT) and intraoperative palpation. Between March 1989 and May 1991, 24 patients underwent 25 IOUS procedures during laparotomy. Intraoperative ultrasound provided more information than the other modalities in 10 patients (40%) and affected operative management in eight patients (32%).

Dual-purpose tube for enteroclysis and nasogastric-nasoenteric decompression.

A catheter designed for the dual purpose of nasogastric-nasoenteric decompression and enteroclysis is described. The catheter facilitates direct decompression of the obstructed small bowel and, if necessary, subsequent performance of enteroclysis. The use of this tube obviates dual intubation and its accompanying discomfort.

Thoracic spine trauma.

Thoracic spine fractures are most commonly flexion injuries resulting from vehicular accidents or falls. The initial evaluation of any multiple trauma victim should include AP and cross-table lateral radiographs of the thoracic spine. Conventional and computed axial tomography can add additional information regarding posterior element integrity and spinal canal encroachment.

Demographics of emergency medical care at the Indianapolis 500 mile race (1983-1990).

Background: The Indianapolis 500 Mile Race, the largest single-day, single-venue sporting event in the world, is attended by an estimated 400,000 people. Major illness and injury are treated at the Hanna Emergency Medical Center, the track hospital. Minor illness is treated at ten outlying aid stations.

Tissue factor in normal and transplanted human kidneys.

Tissue factor (TF) plays a central role in the initiation of blood coagulation that frequently is enhanced in renal allografts. The identification and localization of TF was studied immunocytochemically in biopsies from normal and transplanted human kidneys and classified according to its distribution. The clinical status of each allograft was then correlated with the TF classifications.

Identification of Streptococcus pneumoniae with a DNA probe.

The Accuprobe Streptococcus pneumoniae Culture Identification Test (Gen-Probe, Inc.) was evaluated with 172 isolates of S. pneumoniae and 204 nonpneumococcal isolates.

Vascular events in placentae and organ allografts.

This investigation explores the transplantation analogy of placentae with allografted human organs. Biopsies of cardiac and renal allografts and placentae were studied immunocytochemically with antibodies to components of the immunological, coagulational, anticoagulational, and fibrinolytic systems. Cellular rejection of cardiac and renal allografts was identified by infiltrating lymphocytes and macrophages.

Immune recognition at the maternal-fetal interface: overview.

Trophoblast antigens at the maternal-fetal interface that are capable of stimulating maternal immune responses have been studied. Candidates are blood group I and P, HLA, Fc gamma-receptors, TLX, and phospholipids. Antigens I and P on trophoblast have been implicated in pregnancy loss but incompatible i,p mothers are rare.

Evolution of the technique of combination therapy for staghorn calculi: a decreasing role for extracorporeal shock wave lithotripsy.

Percutaneous nephrostolithotomy with or without extracorporeal shock wave lithotripsy (ESWL) has been extensively used in the management of staghorn calculi, with stone-free rates varying from 23 to 86%. Explanations for the variability of such results include differences in stone burden, differences in percutaneous techniques and an overreliance on ESWL. The results and changing trends in the relative roles of percutaneous nephrostolithotomy and ESWL in the management of staghorn calculi at the Methodist Hospital of Indiana were examined.

Stone surface area determination techniques: a unifying concept of staghorn stone burden assessment.

The use of stone surface area measurements obtained from standard radiographs provides a more accurate and reproducible assessment of stone burden when reporting results and treatment recommendations for staghorn calculi. Techniques for determining stone surface area include use of graph paper, planimeter or computerized image analysis. The use of graph paper is inefficient while planimeters suffer from significant variation for areas less than 500 mm.

Pelvic prolapse: assessment with evacuation proctography (defecography).

The contribution of evacuation proctography (EP) to the evaluation of pelvic prolapse was assessed in 74 consecutive patients. A rectocele was demonstrated in 73 patients (99%); large rectoceles frequently showed barium trapping, but there was no correlation between these findings and rectal symptoms. An enterocele was detected at evacuation proctography in 13 patients (18%) (including two enteroceles seen only retrospectively), and a sigmoidocele was shown in four patients (5%).