Skin aging. Effect on transepidermal water loss, stratum corneum hydration, skin surface pH, and casual sebum content.

This study investigates the effect of cutaneous aging on transepidermal water loss, stratum corneum hydration (capacitance), skin surface pH, and causal sebum content. Because the physiologic condition of skin varies considerably with anatomic region and skin aging might demonstrate regional variability, all factors were studied on 11 anatomic locations in 14 young adult (seven female and seven male subjects; 26.7 +/- 2.

Comparison of four objective methods of monitoring digital venous congestion.

This study sought to determine which of the four most commonly used objective monitoring modalities--pulse oximetry, laser Doppler flowmetry, skin surface temperature measurement, and skin surface fluorescence--is best able to detect early digital venous congestion. Digital venous congestion was induced in 12 hands by inflating a digital cuff to 5 mm Hg above the resting diastolic pressure. The cuff remained inflated for 1 hour while monitoring was done at 10-minute intervals.

13-cis retinoic acid enhances in vivo B-lymphocyte differentiation in patients with common variable immunodeficiency.

Retinoic acid (RA) has been demonstrated to drive both phenotypic and functional in vitro differentiation of B cell hybridomas from patients with common variable immunodeficiency (CVI) who manifest an "intrinsic" defect in terminal B cell differentiation (J Exp Med 1988;168: 55-71). Therefore, we conducted an open trial to determine the effects of oral 13-cis RA (0.5 mg/kg/day; 12 weeks receiving and 12 weeks without drug) on in vivo B cell differentiation in subjects with CVI.

Simple method of documenting metatarsus adductus.

A simple, accurate, and inexpensive method of documenting metatarsus adductus involves taking photocopies of the foot in the weightbearing position. Subsequently, treatment progress can be assessed objectively by reviewing serial photocopies. Some caution is urged because the strength of the glass copying surface of photocopying machines is unknown.

Trans-dominant Tat mutants with alterations in the basic domain inhibit HIV-1 gene expression.

The Tat protein of the human immunodeficiency virus type 1 (HIV-1) is required for efficient viral gene expression. By means of mutational analyses, several domains of the Tat protein that are required for complete activation of HIV-1 gene expression have been defined. These include an amino-terminal activating domain, a cysteine-rich dimerization domain, and a basic domain important in the binding of Tat to the trans-activation response element (TAR) and in Tat nuclear localization.

Multiple modes of engrailed regulation in the progression towards cell fate determination.

The engrailed gene product of Drosophila specifies the fate of a subset of cells in each segment. Our studies of engrailed regulation suggest that fate determination is an elaborate, multistep process. At the time in embryogenesis when the engrailed-dependent cell fate is probably determined, four modes of control act in an overlapping progression to govern engrailed expression.

Characterization of human immunodeficiency virus type 1 strains recovered from the bowel of infected individuals.

HIV-1 isolates were recovered from biopsy tissues from the small bowel, colon, and rectum of 10 infected individuals with severe diarrhea. In general, the bowel strains grew well in primary macrophage and lymphocyte cultures, not in T or B cell lines. They induced cytopathic effects such as syncytia formation and cell killing in peripheral blood mononuclear cells and were usually sensitive to serum neutralization.

Ischemic brain damage: reduction by sodium-calcium ion channel modulator RS-87476.

A novel sodium-calcium ion channel modulator, RS-87476, reduced cerebral infarct size in cats subjected to permanent unilateral occlusion of the middle cerebral artery. Cerebral injury was assessed in vivo with a combination of magnetic resonance (MR) imaging and spectroscopy for 5-12 hours after occlusion and was compared with the area of histochemically ischemic brain tissue. Compared with infarcts in placebo-treated animals, infarcts in cats given RS-87476 were reduced by an average of 70% at the lowest dose, 75% at the intermediate dose, and 88% at the highest dose.

Diagnosis and antibiotic treatment of community-acquired pneumonia.

Only a few pathogens cause most community-acquired pneumonias. In outpatients, treatment is empiric, based on the results of chest films, leukocyte counts, and Gram's stains (if available). Antibiotics must always cover pneumococci and should cover Mycoplasma pneumoniae in young adults and during epidemic periods.

Demographics and cigarette smoking among women.

Background: A population-based sample of 893 white women ages 25 to 59 years from five San Francisco, California, Bay Area counties were queried about their demographic characteristics, height, reported weight at age 25, cigarette smoking history, and oral contraceptive and sunscreen use.

Methods: Multiple logistic regression techniques were used to analyze the data. Forty-three percent of the women in the sample had never smoked more than 100 cigarettes, while 27% were current and 30% were former smokers.

The Allen's test: analysis of four methods.

Forty nonrandomly selected hands were studied with use of four types of Allen's test: (1) the digital systolic blood pressure method, (2) the subjective method, (3) the pulse oximeter method, and (4) the laser Doppler flowmetry method. The digital systolic blood pressure method, regarded as the standard, indicated abnormal pressure in three hands. Laser Doppler flowmetry gave the same results as those obtained by the digital systolic pressure method and, in addition, was easier to perform.

Treatment of comminuted femoral subtrochanteric fractures using the Russell-Taylor reconstruction intramedullary nail.

Seven patients with comminuted subtrochanteric fractures of the femur were treated with Russell-Taylor reconstruction intramedullary nails. Six of the seven fractures were AO/ASIF Type C and had resulted from high-energy trauma. The average time to clinical union was 10.

Female urethra: MR imaging.

The potential of magnetic resonance (MR) imaging in the evaluation of the female urethra was studied in 64 patients. Spin-echo T1- and T2-weighted images were obtained in all 64 patients, and contrast-enhanced T1-weighted images were also obtained in 27 patients. Urethral pathologic conditions, established with urethroscopy or histologic examination, or both, included urethral diverticula, inflammatory granuloma, and primary and metastatic neoplasms.

Pathogenesis of pulmonary edema during interleukin-2 therapy: correlation of chest radiographic and clinical findings in 54 patients.

The pathogenesis of pulmonary edema that occurs during interleukin-2 therapy has often been attributed to an increase in pulmonary capillary permeability. However, renal insufficiency, fluid overload, and hypotension also develop in many patients. These manifestations of systemic toxicity may contribute to the development of pulmonary edema during therapy.

An adverse wound environment activates leukocytes prematurely.

This study was designed to evaluate the effect of different wound environments on wound activation. Our wound model provided two distinct environments, a well vascularized musculocutaneous flap and a poorly perfused random-pattern flap, in miniature swine. Leukocytes were isolated and analyzed by the following three variables: surface and total cellular Mac-1 (CD11b/CD18), superoxide anion expression, and lactoferrin release.

Identification of herpes simplex virus DNA in lesions of erythema multiforme by the polymerase chain reaction.

An association between erythema multiforme and herpes simplex virus infection has been supported by clinical studies and by the detection by immunofluorescence of herpes viral antigen in sera and skin biopsy specimens of patients with erythema multiforme. In rare cases, the virus has also been isolated in cultures of skin biopsy specimens of erythema multiforme. To investigate further the association between erythema multiforme and herpes simplex virus, we used the polymerase chain reaction for herpes simplex virus to examine skin lesions from patients with erythema multiforme.

Laboratory data predicts survival post hospitalization.

From a database of 93,077 in-patient admissions, patients assigned to catastrophic, very severe, moderately severe, and average 30-day mortality risk categories (as defined in Medicare Hospital Mortality Information, 1989 release, from the Health Care Financing Administration (HCFA] were selected for study. These admissions account for 30% of all admissions, but 70% of all deaths up to 1 year post admission. To determine whether laboratory information adds to the predictive power of the information used by HCFA, we compare the performance of 1 year survival predictors (Cox model) that use only diagnostic, demographic, and comorbidity information, with the performance of predictors that also include laboratory information.

In vivo defibrination results in markedly decreased amounts of fibrinogen in rat megakaryocytes and platelets.

Recently evidence was provided for a pathway whereby circulating fibrinogen enters megakaryocyte granules by an endocytic mechanism. Synthesis of fibrinogen by megakaryocytes has been reported. To determine the relationship between plasma fibrinogen and alpha-granule fibrinogen in megakaryocytes and platelets, the fibrinogen content of these cells was studied in rats defibrinated by use of Ancrod, a thrombinlike enzyme purified from the venom of Agkistrodon rhodostoma.

Elevated serum interleukin-6 associated with a failure in B cell differentiation in common variable immunodeficiency.

Interleukin-6 (IL-6/B cell stimulatory factor 2) has been found to drive activated human B-lymphocytes through the final stages of differentiation to become immunoglobulin-producing cells. Most patients with common variable immunodeficiency (CVI) have B-lymphocytes that fail to differentiate into high-rate immunoglobulin-secreting cells in vivo and in vitro. In view of (1) the known effects of IL-6 to promote B-lymphocyte terminal differentiation and (2) the defect in differentiation in B-lymphocytes of patients with CVI, we believed that it was important to analyze the role of this cytokine in patients with CVI.

Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase.

The pancreatic islet beta-cell autoantigen of relative molecular mass 64,000 (64K), which is a major target of autoantibodies associated with the development of insulin-dependent diabetes mellitus (IDDM) has been identified as glutamic acid decarboxylase, the biosynthesizing enzyme of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid). Pancreatic beta cells and a subpopulation of central nervous system neurons express high levels of this enzyme. Autoantibodies against glutamic acid decarboxylase with a higher titre and increased epitope recognition compared with those usually associated with IDDM are found in stiff-man syndrome, a rare neurological disorder characterized by a high coincidence with IDDM.

Osteomyelitis caused by nail biting.

Nail biting is a common habit in children. In most cases, it is of cosmetic concern only; however, if not controlled, it can lead to serious morbidity. A case is presented of a child who developed osteomyelitis of a distal phalanx as a result of chronic nail biting.

Somatostatin inhibits pancreatic exocrine secretion via a neural mechanism.

The mechanism of inhibition of pancreatic exocrine secretion by somatostatin is unknown. We hypothesized that somatostatin acts indirectly, via intrinsic pancreatic neurons, to inhibit pancreatic exocrine secretion. To test this hypothesis, amylase and volume outputs in response to secretin (10(-8) mol/L) and cholecystokinin octapeptide (CCK) (10(-8) mol/L) were studied in the rat isolated, perfused, pancreas model.

Iron deficiency: improved exercise performance within 15 hours of iron treatment in rats.

We tested the hypothesis that a very rapid improvement in exercise performance of iron-deficient rats after treatment with iron might reveal a rate-limiting role of ionic iron as an enzyme cofactor in energy metabolism. Rats were given iron-deficient or control diets after weaning at 21 d of age and intraperitoneal iron dextran (50 mg/kg) at 45 d of age. Time to fatigue during an easy walking exercise (endurance) was measured 15 and 18 h after iron dextran or saline injection.