An unusual cause of dysphagia following total laryngectomy.

A case of dysphagia following wide-field total laryngectomy with excision of the overlying skin is presented. Initial investigation as to the cause of the dysphagia proved fruitless. Mechanical compression of an adequate-sized neopharynx by the "band-like effect" created by the skin closure was hypothesized to be the etiology of the dysphagia.

Clostridium difficile toxin B activates calcium influx required for actin disassembly during cytotoxicity.

The principal cellular response to Clostridium difficile toxin B, a protein toxin associated with antibiotic-associated colitis, is the disassembly of actin microfilaments. Although receptor-activated signal transduction mechanisms have been proposed to mediate these effects, the intracellular events that precede actin breakdown are unknown. In NIH-3T3 fibroblasts, toxin B induced an elevation of intracellular calcium possessing either a slow (minutes) or fast (seconds) rise time, followed by a sustained elevation of calcium concentration.

Vascular Applications of Human Gene Therapy.

Complexing recombinant DNA with cationic liposomes is a convenient means of introducing foreign genes into cells (lipofection) and could potentially form the basis for genetically modifying diseased blood vessels in patients. The mechanism of lipofection is incompletely understood, but it is recognized that the degree of successful gene transfer is highly dependent on cell type. We have transfected primary cultures of human vascular smooth muscle cells with a plasmid expressing either firefly luciferase (Luc) or nuclear-localized beta-galactosidase (NL-beta-gal).

Adult daughters of alcoholics: are they unique?

To test the assertion in the clinical literature that adult children of alcoholics (ACOAs) are uniquely impacted by their parents' alcohol abuse, 25-35 year old daughters (N = 184) of alcohol-abusing, psychiatrically distressed, comorbid and normal parents were compared on measures of fear of intimacy, generalized psychological distress, perceived love inconsistency from parents and perceived interparental conflict. Neither fear of intimacy nor daughters' psychological distress differed across groups. Daughters of psychiatrically distressed and comorbid mothers recalled greater love inconsistency from mother than from father.

A novel mobile element inserted in the alpha spectrin gene: spectrin dayton. A truncated alpha spectrin associated with hereditary elliptocytosis.

Nonviral retrotransposons, retropseudogenes, and short interspersed nuclear elements (SINEs) are mobile DNA segments capable of transposition to new genomic locations, where they may alter gene expression. De novo integration into specific genes has been described in both germ and somatic cells. We report a family with hereditary elliptocytosis and pyropoikilocytosis associated with a truncated alpha-spectrin protein.

Serine-rich region of the IL-2 receptor beta-chain is required for activation of phosphatidylinositol 3-kinase.

The intracellular portion of the IL-2 receptor (IL-2R) signal transducing beta-chain contains a distinct region, designated "serine-rich," which encompasses sequences required for IL-2-mediated cell growth. Although the receptor does not possess intrinsic protein-tyrosine kinase activity, IL-2 binding induces activation of intracellular protein-tyrosine kinases. Activation of many protein-tyrosine kinases leads to activation of phosphatidylinositol 3-kinase (PI 3-kinase).

Phosphorylation of protein 4.1 in Plasmodium falciparum-infected human red blood cells.

The composition of the erythrocyte plasma membrane is extensively modified during the intracellular growth of the malaria parasite Plasmodium falciparum. It has been previously shown that an 80-kD phosphoprotein is associated with the plasma membrane of human red blood cells (RBCs) infected with trophozoite/schizont stage malaria parasites. However, the identity of this 80-kD phosphoprotein is controversial.

Electroencephalographic abnormalities in monozygotic twins with Tourette's syndrome.

The association of attentional, neuropsychological, and behavioural abnormalities with Tourette's syndrome (TS) suggests that the abnormal function of the disorder extends beyond the motor circuits of the basal ganglia. To explore this possibility we studied, with conventional 18-channel electroencephalography, monozygotic twins ranging from 8 to 26 years of age, where at least one member of the twin pair suffered from TS. In nine out of the 11 twin pairs that differed in clinical severity of the tic disorder, the twin with the more severe course of illness had a significantly more abnormal electroencephalogram (EEG) by qualitative visual analysis.

Regional differences in the distribution of the proteoglycans biglycan and decorin in the extracellular matrix of atherosclerotic and restenotic human coronary arteries.

Proteoglycans are important constituents of blood vessels and accumulate in various forms of vascular disease. Little is known concerning the proteoglycan composition of restenotic lesions formed after angioplasty and whether the proteoglycan composition of these lesions differs from that of primary atherosclerosis. Accordingly, we sought to characterize the distribution of two proteoglycans, biglycan and decorin, in primary atherosclerotic and restenotic lesions of human coronary arteries.

Intensive care of acute Guillain-Barré syndrome.

Guillain-Barré syndrome causes, in addition to paralysis and respiratory failure, many general medical problems that have great bearing on outcome. The main features of daily care that require attention are: respiratory and urinary tract infections, gastrointestinal dysfunction, hyponatremia, pain control, and the potential for pulmonary embolism. Dysautonomic problems that arise specifically in the intensive care unit include: hyper- and hypotension, cardiac arrhythmias, and ileus.

Variable expression of the estrogen receptor in normal and atherosclerotic coronary arteries of premenopausal women.

Background: The relative absence of coronary atherosclerosis in premenopausal women has been established. Estrogen is presumed to play a role in the protection of coronary arteries from atherosclerosis, and part of this protective effect appears to be mediated by amelioration of serum lipid profiles. However, all of the atheroprotective effect of estrogen is not explained by alteration of serum lipids.

Prospects for site-specific delivery of pharmacologic and molecular therapies.

The local delivery of therapeutic agents to the arterial wall represents a new strategy for the treatment of vascular diseases, including restenosis. Approaches for local, intravascular, site-specific delivery include 1) direct deposition of therapeutic agents into the vessel wall through an intravascular delivery system; 2) systemic administration of inactive agents followed by local activation; and 3) systemic administration of fusion toxins that have a specific affinity to proliferating smooth muscle cells at the angioplasty site. In addition to conventional drugs, new therapeutic agents based on molecular mechanisms, including recombinant genes and antisense oligonucleotides, are now under investigation.

Calcium efflux from an intracellular pool activated by GTP hydrolysis in cultured gastric smooth muscle.

In these studies, we have characterized calcium movement due to guanosine triphosphate (GTP) hydrolysis from an ATP-sequestered intracellular calcium pool in cultured gastric smooth muscle. GTP (1-100 microM), when added to an ATP-regenerating medium, resulted in a concentration-dependent and irreversible efflux of calcium from an organellar calcium pool. GTP-induced calcium efflux was not affected by variation of the ATP/ADP ratio (8.

Use of the rabbit ear artery to serially assess foreign protein secretion after site-specific arterial gene transfer in vivo. Evidence that anatomic identification of successful gene transfer may underestimate the potential magnitude of transgene expression.

Background: The development of molecular strategies for the treatment of restenosis has been hindered by low efficiencies of in vivo arterial transfection. Expression of intracellular marker proteins is generally evident in < 1% of vascular smooth muscle cells after in vivo arterial transfection. Efforts to improve the efficiency of in vivo gene transfer have been further impeded by the use of transgenes encoding for intracellular marker proteins, necessitating tissue removal and limiting survey for expression to one point in time.

Primary structure, ligand binding, and localization of the human type 3 inositol 1,4,5-trisphosphate receptor expressed in intestinal epithelium.

The second messenger, inositol 1,4,5-trisphosphate (InsP3) transduces many hormonal signals which regulate Ca(2+)-dependent processes in the intestinal epithelium. To study the receptors for InsP3 (InsP3Rs), which function as intracellular Ca2+ channels, cDNA clones encoding InsP3Rs were isolated from a human colon adenocarcinoma cell line, HT29. The majority of clones encoded the type 3 InsP3R, the product of the ITPR3 gene on chromosome 6, for which only a 147-amino-acid fragment was known previously (Ozcelik, T.

Persistently increased expression of the transforming growth factor-β1 gene in human vascular restenosis: Analysis of 62 patients with one or more episode of restenosis.

Transforming growth factor-beta-1 (TGF-β1) is a multifunctional cytokine with both growth-promoting and growth-inhibiting properties. Moreover, there is abundant evidence that TGF-β1 is the principal growth factor responsible for regulating proteoglycan synthesis in human blood vessels. To determine the potential contribution of TGF-β1 to restenosis, the current investigation sought to determine the time course of expression postangioplasty of the TGF-β1 gene.

Duplication of 10 nucleotides in the erythroid band 3 (AE1) gene in a kindred with hereditary spherocytosis and band 3 protein deficiency (band 3PRAGUE).

We describe a duplication of 10 nucleotides (2,455-2,464) in the band 3 gene in a kindred with autosomal dominant hereditary spherocytosis and a partial deficiency of the band 3 protein that is reflected by decreased rate of transmembrane sulfate flux and decreased density of intramembrane particles. The mutant allele potentially encodes an abnormal band 3 protein with a 3.5-kD COOH-terminal truncation; however, we did not detect the mutant protein in the membrane of mature red blood cells.

Liposome-mediated gene transfer into human vascular smooth muscle cells.

Background: Complexing recombinant DNA with cationic liposomes is a convenient means of introducing foreign genes into cells (lipofection) and could potentially form the basis for genetically modifying diseased blood vessels in patients. The mechanism of lipofection is incompletely understood, but it is recognized that the degree of successful gene transfer is highly dependent on cell type. To date, there has been no reported experience with lipofection of human vascular smooth muscle cells.

Nurse characteristics and professional autonomy.

Relationships between selected demographic characteristics and professional nursing autonomy were examined. Identification of such relationships can strengthen development of the professional nursing role. Usable responses were returned by 542 RNs in a random sample of 2,000 nurses from four states.

Healing of transsphincteric perianal fistulas in Crohn's disease using a new technique.

Objectives: Transsphincteric perianal fistulas in Crohn's disease are often refractory to medical therapy and difficult to treat surgically. Our objective was to determine whether a new method of anal fistulotomy was effective in healing these fistulas.

Methods: In this new method, the internal opening of the fistula tract was displaced distally to the region of the anal mucosa in 26 patients with Crohn's disease.

Arterial gene transfer using pure DNA applied directly to a hydrogel-coated angioplasty balloon.

Direct arterial gene transfer has been previously achieved using double-balloon catheters and perforated balloons, in most cases facilitated by the use of cationic liposomes or viral vectors. These gene delivery systems, however, have been compromised by issues relating to efficacy and/or safety, and furthermore require that angioplasty be performed independent of gene transfer. We investigated the possibility that arterial gene transfer might be performed during balloon angioplasty by delivery of naked genetic material from a thin coat of hydrogel polymer applied to a standard angioplasty balloon.

Spectrin cagliari. an Ala-->Gly substitution in helix 1 of beta spectrin repeat 17 that severely disrupts the structure and self-association of the erythrocyte spectrin heterodimer.

The spectrin tetramer, the principal structural element of the red cell membrane skeleton, is formed by stable head-to-head self-association of two spectrin heterodimers. The self-association site appears to be formed by interactions between helices 1 and 2 of beta spectrin repeat 17 of one dimer with helix 3 of alpha spectrin repeat 1 of the other dimer to form two combined alpha-beta triple-helical segments. The head of the heterodimer appears to involve similar intradimer interactions.

Origin of neurohypophyseal neuropeptide-FF (FLFQPQRF-NH2).

Neuropeptide-FF (FLFQPQRF-NH2), originally isolated from bovine brain, is an FMRF-NH2-like peptide with morphine-modulating activity. Neuropeptide-FF (NPFF) is unevenly distributed in the central nervous system, with the highest concentrations in posterior pituitary and spinal cord. In the rat pituitary, NPFF is found exclusively in the neural lobe, where it is localized in nerve terminals and fibers, indicating the hypothalamus as a possible source of the neural lobe NPFF.