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ABSTRACTThe purpose of this study was to assess the association between binge alcohol use and unprotected sex in Russian substance users. Participants (N= 181) were narcology hospital patients assessed on demographics, alcohol use, risky sex, and sexually transmitted disease/human immunodeficiency virus (STD/HIV) diagnoses. Adjusted generalized estimating equations (GEEs) logistic regression analysis examined the association between binge drinking and same-day unprotected sex across each of the past 30 days, per participant (N= 5430 observations). Participants were age 18 to 55 years, 75% male, and 64% binge drinking. Sex trade was reported by 27%; history of STDs by 43%; and HIV by 15%. One fourth of daily observations included sex; 88% of these involved unprotected sex. Binge drinking was not associated with same-day unprotected sex (adjusted odds ratio [ORadj] = 1.0, 95% confidence interval [CI] = 0.7–1.4, χ2(1, N= 5219) = 0.01, ns). Findings document substantial HIV/STD risk and prevalence among Russian narcology patients, but no link between binge drinking and unprotected sex in this population, possibly due to very low rates of condom use generally.

The purpose of this study was to assess the association between binge alcohol use and unprotected sex in Russian substance users. Participants (N= 181) were narcology hospital patients assessed on demographics, alcohol use, risky sex, and sexually transmitted disease/human immunodeficiency virus (STD/HIV) diagnoses. Adjusted generalized estimating equations (GEEs) logistic regression analysis examined the association between binge drinking and same-day unprotected sex across each of the past 30 days, per participant (N= 5430 observations). Participants were age 18 to 55 years, 75% male, and 64% binge drinking. Sex trade was reported by 27%; history of STDs by 43%; and HIV by 15%. One fourth of daily observations included sex; 88% of these involved unprotected sex. Binge drinking was not associated with same-day unprotected sex (adjusted odds ratio [ORadj] = 1.0, 95% confidence interval [CI] = 0.7–1.4, ?2(1, N= 5219) = 0.01, ns). Findings document substantial HIV/STD risk and prevalence among Russian narcology patients, but no link between binge drinking and unprotected sex in this population, possibly due to very low rates of condom use generally.

Vibrational end discharge of free-flowing material is considered. Principles permitting significant expansion of the flow zone and more complete use of the reservoir volume are established.

Study objective: To test the feasibility and effectiveness of Project ASSERT, an innovative program developed by us to facilitate access to the substance abuse treatment system and to primary care and preventive services for emergency department patients with drug- and alcohol-related health problems. Methods: Multicultural health promotion advocates (HPAs) were trained by ED personnel to screen patients using a health needs history, to administer a brief negotiated interview based on readiness-to-change principles, and to use an active referral process to capture the marginal capacity of the substance abuse treatment system. Outcome measures included (1) number of referrals to the substance abuse treatment system, (2) patient self-report of satisfaction with services received from Project ASSERT and utilization of treatment resources, and (3) changes in self-reported frequency of drug and alcohol use and in Drug Abuse Screening Test scores between enrollment and follow-up at 60 to 90 days. Results: Between March 1, 1995, and February 29, 1996, 7,118 adult ED patients were screened. Substance abuse was detected among 2,931 patients (41%), and 1,096 (37% of detected patients) were enrolled. A total of 8,848 referrals were made: 3,189 to primary care, 2,018 to a variety of substance abuse treatment services, 2,253 for smoking cessation, 339 for mammography, and 689 to other support services (eg, psychiatric nurse, social worker, battered women's advocate or shelter). Comparison of enrollment and follow-up scores for the 245 enrollees who kept a follow-up appointment demonstrated significant reductions, including a 45% reduction in severity of drug problem, a 56% reduction in alcohol use, and a 64% reduction in the frequency of drinking six or more drinks at one sitting. At follow-up, patients expressed satisfaction with Project ASSERT: 91% were satisfied with their referrals; 93% thought the HPAs explained things well; and 99% thought the HPAs respected them as individuals. Among the follow-up group, 50% self-reported that they had kept an appointment for treatment. Conclusion: Project ASSERT is an innovative approach to link ED patients with the substance abuse treatment system and with primary care and other preventive services. Its success is further demonstrated by its adoption by Boston Medical Center as a funded ED value-added service. [Bernstein E, Bernstein J, Levenson S: Project ASSERT: An ED-based intervention to increase access to primary care, preventive services, and the substance abuse treatment system. Ann Emerg Med August 1997;30:181-189.]

Hepatocytes harvested by collagenase perfusion of rat liver were attached to collagen-coated microcarriers and injected intraperitoneally into congeneic or allogeneic bilirubin-UDP-glucuronosyltransferase (EC 2.4.1.17)-deficient (Gunn) rats or allogeneic analbuminemic (NAR) rats. Five days later, the microcarriers were observed to have formed conglomerates chiefly on the anterior surface of the pancreas. Scanning electron microscopy showed hepatocytes attached to the granular collagen-coated surface of the microcarriers and newly formed connective tissue. Light microscopy revealed that the microcarriers formed a lattice with the collagen tissue; hepatocytes were seen within this lattice or on the surface of the microcarriers. Hepatocyte plasma membranes were nucleoside-diphosphatase (NDPase)-positive. Newly formed blood islands, blood vessels containing erythrocytes and leukocytes and NDPase-positive endothelium were observed in close proximity to the hepatocytes and fibroblasts. Transmission electron microscopic examination showed hepatocytes with microvilli and nucleoid-containing peroxisomes with catalase activity. Hepatocytes were present for up to 2 months in congeneic recipients, the longest period of observation after transplantation. After normal microcarrier-attached hepatocytes were transplanted into allogeneic Gunn rats, bilirubin glucuronides were present in bile for 6 days. When congeneic Gunn rat recipients were used, bilirubin glucuronides were present in bile throughout the study (28 days); this was accompanied by reduction of serum bilirubin concentrations to nearly normal levels. After injection of normal hepatocytes into allogeneic NAR rats, plasma albumin concentration progressively increased for 6 days and then declined. In NAR recipients which were immunosuppressed with cyclosporin A, peak plasma albumin levels were reached in 14 days and persisted nearly at that level throughout the study (28 days).

Gastric secretions were studied in rats by pyloric ligation in vivo. The effects of epidermal growth factor (EGF) administered s.c. on gastric secretion were evaluated at different stages of development (8, 14, 20 and 30 postnatal days). The rates of fluid, protein and acid outputs were very low in developing rats but increased in maturing rats. The rate of acid output in 8- day-old rats (3.83 +/- 1.16) was not different from that in 14-day-old rats (4.84 +/- 0.99), whereas the rate of acid output in 20-day-old rats was 11-fold greater than that in 14-day-old rats, and it was 21-fold greater in 30-day-old rats. Subcutaneous administration of 30 micrograms/kg b.wt. of EGF significantly suppressed the gastric secretion of fluid, protein and acid in 20- and 30-day-old rats. In 30-day-old rats, acid output was 85% lower at 1 hr after EGF administration and in 20-day-old rats it was 85% lower at 2 hr and 50% lower at 3 hr. Interestingly, EGF had no effect on basal gastric secretions in 8- and 14-day-old rats; EGF also had no effect on the gastric acid output that was stimulated by pentagastrin administration in 14-day-old rats. In 20-day-old rats, inhibitory effects of EGF lasted for 3 hr before gastric secretions rebounded to normal levels, but inhibition lasted for only 1 hr in 30-day-old rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Cimetidine, an H-2 antagonist, is one of the most commonly prescribed drugs and is used in the management of peptic ulcer disease and prevention of stress ulcerations following major trauma or operations. It has been shown that histamine has a stimulatory effect on wound healing which is believed to be mediated through H-2 receptors. We hypothesized that cimetidine would have an inhibitory effect on wound healing. Fifty-two adult rats were divided into two groups: Group A was placed on a standard chow and Group B was given chow supplemented with cimetidine (300 mg/Kg diet), a dose equivalent to that clinically used in man and effective in inhibiting gastric hypersecretion in the rat. Ten days later, all rats underwent a dorsal skin incision under pentobarbital anesthesia and implantation of a polyvinyl alcohol sponge subcutaneously. Animals were maintained on their respective diets. Rats were killed with ether five and ten days postoperatively, the wounds were excised and breaking strength measured. Sponge hydroxyproline content was measured. No significant difference in breaking strength or sponge hydroxyproline content was found between the two groups. We thus conclude that cimetidine has no effect on wound healing in rats when used in doses equivalent to the clinical dose in man.

The effects of cholecystokinin (CCK) fragments and Asp-Tyr-D-Phe-Gly-Trp-[N-Me]Nle-Asp-Phe-NH2 1(SNF 9007), a synthetic CCK analog which binds with high affinity to CCKB and opioid delta receptors, were evaluated in isolated sheets of mouse ileum mounted in Ussing flux chambers. Serosal, but not mucosal, administration of cholecystokinin octapeptide-sulfated [CCK8(s)] and cholecystokinin tetrapeptide (30-33) [CCK4(30-33)] produced a brief, concentration-related increase in short circuit current (Isc) without changing tissue conductance. Serosal, but not mucosal, SNF 9007 produced a similar concentration-related increase in Isc which was followed by an immediate concentration-related and sustained decrease in Isc; no decrease in Isc was observed for either CCK8 or CCK4(30-33). The increase and subsequent decrease in the SNF 9007 Isc response were respectively classified as phase I (i.e., CCK-like) and phase II (opioid-like) activity. CCK8(s) and SNF 9007 (phase I) were active at low nanomolar concentrations, whereas CCK4(30-33) was active only at high nanomolar concentrations: the rank order of potencies to increase Isc was CCK8(s) > SNF 9007 > CCK4(30-33). Devazepide (L364,718), a selective antagonist of CCKA receptors, effectively blocked the action of CCK8(s), but not that of CCK4(30-33) or SNF 9007 (phase I). In contrast, 3R[+]-N-[2,3-dihydro-1-methyl-2-oxo-5-phenyl-1H-benzodiazepin-3-yl ]-N'- [3-methyl-phenyl]urea (L365,260), a selective CCKB receptor antagonist, blocked the action of CCK4(30-33) and SNF 9007 (phase I), and also antagonized CCK8(s), though to a lesser degree.(ABSTRACT TRUNCATED AT 250 WORDS)

ALTERATIONS in the metabolism of proteins, carbohydrates and electrolytes following burns have been extensively studied in the past few years. In contrast, few investigations of possible changes in vitamin metabolism following burns have been made. Uzbekov,1 Clark and Rossiter2 and Harkins3 have reported decreased ascorbic acid content of the adrenal cortex in burned guinea pigs and rabbits, while Lam4 has reported a decrease in the plasma ascorbic acid concentration in

1. Phosphate exchange in red cells and plasma was studied in vitro using P32 in the form of sodium phosphate as a tracer. 2. No phosphate was added other than the isotopic preparation which was of high specific activity. 3. Inorganic phosphate exchanged freely between the plasma and the erythrocytes at 37.5 C. in a period of four hours. Minimal transfer occurred at 7 C. 4. Most of the added P32 which passed into the erythrocytes during this time remained in the inorganic fraction, less than 15 per cent being found in the organic acid soluble fraction. 5. The specific activity of the inorganic phosphate of the erythrocytes was equal to or greater than that obtaining for the inorganic phosphate of the plasma at the end of the four hour incubation period at 37.5 C.

The subcutaneous administration of testosterone propionate depressed the rise in urinary nitrogen excretion following burns in male and female rats. The effect of testosterone propionate in reducing the total urinary nitrogen excretion of male and female adult rats is essentially unchanged by a thermal burn for a period of 8 days after the burn or onset of the testosterone medication. For 2 to 4 days after this period the effect of the drug post-burn is no longer evident. In normal female animals the effectiveness of testosterone propionate continues for at least 18 days whereas in normal males it disappears at 12 to 14 days. Possible reasons for this wearing-off of the effectiveness of testosterone propionate after burns are considered. Various problems connected with the possible use of testosterone. propionate in the damaged patient are discussed.A part of this report is based on work done by Capt. Braasch in the Department of Physiology of the University of Illinois School of Medicine in partial fulfillment of the requirements for the degree of Master of Science in Physiology. The authors wish to thank the Schering Corporation for a generous supply of testosterone propionate.

The R.E.S., which is the main defense against endotoxin, plays no part in the defense against staphylococcal toxin. The kidneys remove staphylococcal toxin from the circulating blood. The toxin or a modification of it is subsequently released, then exerts a lethal action elsewhere. For some hours after it is taken up by the kidney the toxin cannot act. Thus, the kidney is protective for some hours. Indeed nephrectomy prevents death from exotoxin. The renal necrosis produced by the toxin in itself is not the lethal lesion, because renal necrosis produced by arterial occlusion does not cause such rapid death as occurs in renal necrosis produced by the toxin.

Serum containing antibody specific for an endotoxin improves uptake of the endotoxin by the damaged R.E. system. But breakdown of the endotoxin taken up by this system is not thereby improved. Such immune sera given to rabbits in severe hemorrhagic shock for the purpose of improving the clearance of circulating endotoxin do not lower the mortality rate.

Nimni and Bavetta1reported a connective tissue disorder in rats fed penicillamine. The disorder was reflected by decreased breaking strength of unwounded and wounded skin, decreased collagen synthesis in polyvinyl sponge implants and a diminished proportion of insoluble to soluble collagen in such granulomas. We have studied this phenomenon in rats and guinea-pigs2–4and have likened it to the lathyritic state induced by feeding β-amino propionitrile, a view also expressed by Nimni5. Penicillamine can be derived6from both the in vitro and the in vivo hydrolysis of penicillin, so we set out to determine whether the feeding of very large doses of penicillin would cause a collagen defect similar to that caused by penicillamine.