Hypoglycemia but not hyperglycemia induces rapid changes in pancreatic beta-cell gene transcription.

The purpose of these studies was to quantify several mRNAs expressed specifically in pancreatic islet cells and known or postulated to be important for insulin release after acute well defined alterations in levels of plasma glucose. Glucose levels were maintained at 50, 120, or 180 mg/dl (2.8, 6.

Increased hepatocyte expression of hepatitis B virus transcription in patients with features of fibrosing cholestatic hepatitis.

Background: Recurrent hepatitis B after liver transplantation may be complicated by fibrosing cholestatic hepatitis. This syndrome is associated with rapid graft failure and is characterized by ballooning degeneration of hepatocytes and abundant viral antigen expression.

Methods: To study this disorder further, in situ hybridization studies were performed on 36 liver biopsy specimens from 14 transplanted patients with recurrent hepatitis B and 18 nontransplanted controls with chronic hepatitis B.

Achieving consensus on withdrawing or withholding care for critically ill patients.

Objective: To examine the decision-making process to withhold or stop life support.

Design: Survey.

Setting: Medical intensive care unit of a tertiary care center.

Expression of 25-hydroxyvitamin D 24-hydroxylase cytochrome P450 in kidney and intestine. Effect of 1,25-dihydroxyvitamin D and age.

To study the mechanism of hormonal regulation of the 25-hydroxyvitamin D 24-hydroxylase, a DNA probe complementary to the published sequence of the recently cloned P450 component [(1991) FEBS Lett. 278, 195] was employed. Young (2 month) and adult (12 month) F344 rats, deficient in 1,25-dihydroxyvitamin D, were given a single dose of 1,25-dihydroxyvitamin D.

Superiority of live attenuated compared with inactivated influenza A virus vaccines in older, chronically ill adults.

Forty-eight older adults with chronic diseases were vaccinated intranasally with live attenuated influenza A/Korea/1/82 (H3N2), CR59 virus. Forty-two (88 percent) CR59 virus recipients became infected with vaccine virus without adverse effects or change in mean pulmonary function even among the 29 infected recipients with moderate to severe chronic obstructive pulmonary disease. Among control groups who received either monovalent or trivalent inactivated influenza virus vaccines intramuscularly, the rates of fourfold rises in serum antibody titer to hemagglutinin (HA) were not different from the rate following CR59 virus inoculation.

Needle holder for use with a biopsy gun.

The authors designed and constructed a simple needle holder device for maintaining the position of the trocar and cannula before performance of computed tomography (CT)- and ultrasonography-guided biopsies with a biopsy gun. The holder can be removed before attachment of the biopsy gun and routine obtaining of tissue. Use of the holder facilitated quicker and easier CT-guided biopsies of the liver (n = 3), pancreas (n = 1), and adrenal gland (n = 1) and of a chest wall tumor.

Enhanced lymphoproliferation to influenza A virus following vaccination of older, chronically ill adults with live-attenuated viruses.

To question whether cellular immunity was stimulated by live-attenuated viruses in older, chronically ill adults, we intranasally inoculated 2 groups of volunteers (n = 37) with 2 different cold-recombinant, live-attenuated influenza A virus vaccines, and measured peripheral blood mononuclear cell responsiveness to influenza antigens and mitogen before and after vaccination. Lymphocyte proliferation to vaccine virus and to heterosubtypic influenza A virus increased postvaccination even in the subpopulation of vaccines who had a 4-fold nasal wash antibody titer rise to vaccine virus hemagglutinin, but no concomitant serum antibody titer rise to hemagglutinin. Vaccines aged greater than or equal to 65 years exhibited a rise in proliferation to vaccine virus postvaccination, as well.

The effect of prescribed daily dose frequency on patient medication compliance.

The objective of this study was to determine the relationship between prescribed daily dose frequency and patient medication compliance. The medication compliance of 105 patients receiving antihypertensive medications was monitored by analyzing data obtained from special pill containers that electronically record the date and time of medication removal. Inaccurate compliance estimates derived using the simple pill count method were thereby avoided.

A randomized, controlled trial of interferon alfa-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. The Hepatitis Interventional Therapy Group.

Background And Methods: Chronic hepatitis B is a common and often progressive liver disorder for which there is no accepted therapy. To assess the efficacy of treatment with interferon, we randomly assigned patients with chronic hepatitis B to one of the following regimens: prednisone for 6 weeks followed by 5 million units of recombinant interferon alfa-2b daily for 16 weeks; placebo followed by 5 million units of interferon daily for 16 weeks; placebo followed by 1 million units of interferon daily for 16 weeks; or observation with no treatment.

Results: Hepatitis B e antigen and hepatitis B viral DNA disappeared from serum significantly more often in the patients given prednisone plus interferon (16 of 44 patients, or 36 percent) or 5 million units of interferon alone (15 of 41; 37 percent) than in the untreated controls (3 of 43; 7 percent; P less than 0.