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Squamous cell carcinoma, a cancer of the cells that form the skin and other membranes, is very hard to treat when it occurs in the head and neck. Various forms of chemotherapy with drugs used alone or in combination have been tried. Regimens that include the drug cisplatinum in combination with other agents have been said to be superior. Cisplatinum alone is known to be the best single agent for end stage (very advanced) squamous cell carcinoma of the head and neck. VAC, a combination of vincristine, adriamycin and cyclophosphamide, is also known to be effective. In this study, 16 patients who had end stage squamous cell carcinoma of the head and neck were treated with cisplatinum alternating with VAC. Eight of the study patients had treatment beginning with cisplatinum followed by VAC; the other eight began with VAC, followed by cisplatinum. The authors originally planned to have 20 patients in the study, but did not because they found that the first 16 patients did less well than those who had received cisplatinum alone in a previous study, in which patients survived for an average of 180 days. In another previous study, patients survived with no treatment for an average of 70 days. The median survival time in this study of VAC and cisplatinum was 62 days, and only two patients achieved any response at all. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pediatric cervical spine injuries constitute approximately 1–2% of all pediatric trauma cases. Usually pediatric vertebral injuries appear as stable A type fractures, whereas B and C type injuries are relatively uncommon. In contrast to adults, the appropriate treatment strategy in children is still controversial and places spine surgeons in complex situations. This article reports the case of a 4-year-old girl with an unstable B type injury at the C6/7 level (AOSpine C6-7: B2 [F4 BL, C7:A1]) with bilateral locked fractures of the facet joints after falling down a flight of stairs. Magnetic resonance imaging (MRI) and computed tomography (CT) were initially performed. The 4‑year-old girl was treated under intraoperative neurophysiological monitoring via open reduction after partial resection of both C7 upper articular processes and nonmetallic monosegmental posterior interlaminar fusion (FiberWire®) at the C6/7 level with temporary immobilization in a halo brace. Clinical and radiological follow-up was carried out after 9 months. The patient suffered no pain or neurological deficits. Plain radiographs revealed a correct cervical alignment with anatomical correction of the initial dislocation. The treatment of highly unstable pediatric B type injuries of the lower cervical spine via open reduction and nonmetallic monosegmental posterior interlaminar fusion results in good clinical and radiological outcomes. A temporary immobilization in a halo brace provides stability until osseous fusion occurs. Kindliche zervikale Wirbelkörperfrakturen machen ca. 1–2 % aller Frakturen bei Kindern aus. Überwiegend handelt es sich bei den kindlichen Wirbelsäulenverletzungen um stabile A‑Frakturen, B‑ und C‑Verletzungen sind eher selten. Im Gegensatz zum Erwachsenen gibt die optimale Behandlung der kindlichen Verletzungen immer noch Anlass zur Diskussion und stellt den Wirbelsäulenchirurgen vor komplexe Herausforderungen. Dieser Beitrag berichtet über den Fall eines 4‑jährigen Mädchens mit instabiler B‑Verletzung in Höhe C6/7 (AOSpine C6-7: B2 [F4 BL, C7:A1]) mit beidseits verhakten Frakturen der Facettengelenke nach einem Treppensturz. Als initiale Diagnostik erfolgte eine Magnetresonanztomographie (MRT) und Computertomographie (CT) der Halswirbelsäule. Das 4‑jährige Mädchen wurde mit intraoperativem Neuromonitoring operiert. Es erfolgten die offene Reposition nach partieller beidseitiger Resektion des Processus articularis superior von C7 und eine metallfreie monosegmentale interlaminäre Fusion in Höhe C6/7 mittels FiberWire®. Additiv erfolgte die temporäre Anlage eines Halo-Fixateurs. Eine klinische und radiologische Verlaufskontrolle erfolgte 9 Monate postoperativ. Das Mädchen beklagte keine Schmerzen oder neurologische Defizite. Die Röntgendiagnostik zeigte das korrekte Alignment der Halswirbelsäule mit anatomischer Reposition der initialen Fehlstellung. Die offene Reposition und kurzstreckige, monosegmentale metallfreie Fusion kann eine adäquate Therapieoption bei kindlicher Luxationsfraktur der HWS darstellen. Additiv muss ein Halo-Fixateur angelegt werden, um eine Retention der HWS bis zur knöchernen Fusion zu sichern.

Background: Octreotide, a synthetic somatostatin analogue that inhibits insulin secretion from pancreatic beta cells, has demonstrated efficacy in sustaining blood glucose in experimental and case reports of sulfonylurea overdoses. We report a case of glyburide overdose requiring six days of octreotide infusion, the longest reported use of constant octreotide infusion in the treatment of sulfonylurea overdose. Case Report: A 23-year-old diabetic female ingested fifty 5 mg tablets of glyburide. On paramedic evaluation 30 minutes after ingestion, she had normal mentation with a D-stick of 73 mg/dL. She was given 25 g of intravenous D50W. In the ED, her glucose level was 87 mg/dL. A second dose of D50W was given and a D5W IV drip was started at 150 cc/h. Oral gastric lavage was performed, returning pill fragments, and 50 g of activated charcoal was given. Over the next two hours, despite increasing the dextrose infusion to a D10W drip at 200 cc/h, she developed symptomatic hypoglycemia with blood glucose levels in the 30s requiring an additional 50 gm of D50W. Three hours after the ingestion, intravenous octreotide was started at 50 mcg/h. At 8 hours, the octreotide drip was increased to 100 mcg/h to maintain the blood glucose near 100 mg/dL. Once octreotide was instituted, no additional D50W boluses were required. The octreotide infusion was reduced on Day 5 and discontinued on Day 7, and the patient was discharged on Hospital Day 8. Conclusion: Octreotide, as an adjunct to IV glucose, helped maintain a stable blood glucose level. Although an optimal dose regimen has yet to be established, octreotide should be considered in the therapy of sulfonylurea overdose where refractory hypoglycemia is encountered., Bui L, Adler D, Keller KH. California Poison Control System, San Francisco, [...]

Das Mammakarzinom ist die häufigste maligne Erkrankung der Frau und die Wirbelsäule dabei der am häufigsten von Metastasen betroffene Teil des Skelettsystems. Aktuelle onkologische Behandlungsstrategien erzielten gerade im letzten Jahrzehnt deutliche Fortschritte hinsichtlich der Überlebenszeit, sodass die Therapie der Wirbelkörpermetastasen zusehends im Fokus des Wirbelsäulenchirurgen steht. Zur Evaluation der Prognose und Wahl der Therapiestrategie sind unterschiedliche Scores beschrieben, welche jedoch lediglich die Tumorentitäten und nicht die tumorspezifischen Phänotypen unterscheiden. Das Mammakarzinom wird seit der Jahrtausendwende in fünf intrinsische Subtypen mit unterschiedlicher Überlebenserwartung klassifiziert. Ziel dieser Arbeit ist die Beschreibung molekularer Prädiktoren bezüglich der Malignität des Mammakarzinoms, um die zu erwartende Überlebenszeit und die Invasivität der Therapie hinsichtlich spinaler Metastasen optimiert abschätzen zu können. Breast cancer is the most common malignancy affecting women and the spinal column is most likely affected by metastases. Modern oncologic treatment options have significantly prolonged survival times in the last decade. Therefore, treatment of vertebral metastases has been of special interest in spine surgery. Different scores are described to evaluate prognosis and to choose correct treatment strategies, which however only differentiate tumor entities and not specific tumor phenotypes. Breast cancer has been classified into five intrinsic subtypes with different survival rates since the turn of the millennium. The aim of this review was to describe molecular predictors of breast cancer malignancy and to better estimate expected survival times and invasiveness of therapies with regard to spinal metastases.

Der komplexeste und zudem beweglichste Abschnitt der Wirbelsäule ist die Halswirbelsäule. Die wichtigste Funktion der Halswirbelsäule ist, den Kopf aufrecht balanciert über dem Rumpf zu halten und dabei den horizontalen Blick, also das Geradeausschauen, zu ermöglichen. Die Halswirbelsäule muss dabei stabil und flexibel genug sein, um das physiologische Bewegungsausmaß zu gewährleisten. Veränderungen des Halswirbelsäulenprofils können die Funktion und die Lebensqualität beeinflussen. Für die Beziehung zwischen dem Alignment und dem horizontalen Blick ist das Verständnis für die Wechselwirkung zwischen den kranio-spino-pelvinen Parameter essenziell. Nun stellt sich die Frage, welche sagittale Form muss die Halswirbelsäule einnehmen, damit sie ihren Funktionen gerecht werden kann. In der Literatur wird die normale Form des sagittalen Halswirbelsäulenprofils kontrovers diskutiert. Es wird allgemein angenommen, dass die physiologische Halswirbelsäulenform stets lordotisch ist. Ist diese Annahme durch Daten in der Literatur zu belegen? Nach Durchsicht der Literatur konnte bezüglich des sagittalen Alignments der zervikalen Wirbelsäule folgende Ergebnisse herausgearbeitet werden: Das ideale Halswirbelsäulenprofil ist häufig lordotisch aber nicht immer, es kann lordotisch, neutral und kyphotisch sein; das ideale Halswirbelsäulenalignment nimmt das sagittale Profil ein, das nötig ist, um den Kopf aufrecht über den Rumpf zu balancieren und den Gradeausblick zu ermöglichen; die Halswirbelsäule harmoniert mit dem sagittalen regionalen Alignment der Brustwirbelsäule (thorakale Kyphose) und dem sagittalem globalen Alignment (SVA): TK (↑) → T1-Slope (↑) → CL (↑),TK (↓) → T1-Slope (↓) → CL (↓),SVA >50 mm: HWS sollte für Geradeausblick lordotisch sein,SVA <0 mm: HWS sollte für Geradeausblick kyphotisch sein. The cervical spine is very complex, and it allows the largest range of motion relative to the rest of the spine. The fundamental function of the cervical spine is to maintain the head balanced over the trunk and to maintain horizontal gaze. The cervical spine must be both stable and flexible to guarantee function. Changes of the sagittal profile of the cervical spine may affect function and quality of life. The relationship between full body alignment and maintaining gaze necessitates a thorough understanding of the cranio-spino-pelvic alignment as a component of balance. Now the question is, what kind of sagittal profile does the cervical spine need for proper function? In the literature, normal sagittal alignment of the cervical spine is controversial. In general, there is the assumption that the alignment is lordotic. Does the data in the literature support this? The present literature review supports the following facts: Ideal cervical spine alignment is mostly lordotic, but not always; ideal cervical spine alignment can be lordotic, neutral or kyphotic; ideal cervical spine alignment is driven by the necessity of supporting the head and maintaining horizontal gaze; the cervical spine is in harmony with regional alignment (thoracic kyphosis) and sagittal global alignment (SVA): TK (↑) → T1 Slope (↑) → CL (↑),TK (↓) → T1 Slope (↓) → CL (↓),SVA >50 mm: the cervical curve should be lordotic to maintain horizontal gaze,SVA <0 mm: the cervical curve should be kyphotic to maintain horizontal gaze.

Die adulte spinale Deformität (ASD) ist ein komplexes Krankheitsbild, welches im letzten Jahrzehnt zusehends in den Fokus des Wirbelsäulenchirurgen rückte. Sagittale und/oder koronare Deformitäten der Wirbelsäule gehen unter Umständen mit erheblichen Auswirkungen auf die Lebensqualität (Behinderung, Schmerz) der Patienten einher. Im Rahmen der radiologischen Diagnostik der gesamten Wirbelsäule werden die bekannten spinopelvinen Parameter ermittelt, wodurch erst eine Klassifikation der ASD möglich wird. Konservative Therapiekonzepte können für milde Formen der ASD ausreichend sein und sollten stets ausgeschöpft werden. Operativ erfordert die ASD aufgrund der Komplexität der Deformität nicht selten das gesamte Spektrum. Dieser Artikel gibt einen Überblick über die Entwicklung der ASD, die korrekte Klassifikation sowie die Indikation zur operativen Therapie. Adult spinal deformity (ASD) is a complex entity that has had emerging significance for spine surgeons in the last decade. Sagittal and/or coronary deformities can have a high impact (disability, pain) on the quality of patients’ life. Radiologic diagnostics determine the common spinopelvic parameters as the basis for classification of ASD. Conservative treatment options may be sufficient in mild cases. The deformity’s complexity frequently demands the entire spectrum of methods and techniques in spinal surgery. This article gives an overview on the development of the ASD, the correct classification as well as the indication for surgical therapy.

Fusobacterium ulceransis a newly described obligately anaerobic Gram-negative, non-spore-forming rod [1] that has been isolated from tropical ulcers. Two morphotypes were described: one resemblingFusobacterium variumand the other Fusobacterium mortiferum[1]. Because of the weak or negative fermentation reactions of most fusobacteria, the standard carbohydrate tests used for identification of anaerobe organisms are of little use for identification, and other rapid and simple methods are needed. We characterized eight F. ulceransstrains using conventional biochemical testing. We further analysed these strains by PCR employing a single non-specific primer AP3 and by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) of whole cell proteins. PCR using a self-designed pair of primers for the amplification of the spacer (intergenic) region between the 16S and 23S rRNA genes, led to the development of genetic markers for species identification. All F. ulceransclinical isolates appeared very similar to each other in all the test parameters, but were distinctly different from the type strains of the two phenotypically similar species, F. mortiferumand F. varium. High similarity in PCR- and protein-profiles also raise the possibility that all these F. ulceransstrains came from one clone. We noted significant differences among the strains of F. mortiferumand F. varium.

Fusobacterium ulcerans is a newly described obligately anaerobic Gram-negative, non-spore-forming rod [1] that has been isolated from tropical ulcers. Two morphotypes were described: one resemblingFusobacterium varium and the other Fusobacterium mortiferum[1]. Because of the weak or negative fermentation reactions of most fusobacteria, the standard carbohydrate tests used for identification of anaerobe organisms are of little use for identification, and other rapid and simple methods are needed. We characterized eight F. ulcerans strains using conventional biochemical testing. We further analysed these strains by PCR employing a single non-specific primer AP3 and by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) of whole cell proteins. PCR using a self-designed pair of primers for the amplification of the spacer (intergenic) region between the 16S and 23S rRNA genes, led to the development of genetic markers for species identification. All F. ulcerans clinical isolates appeared very similar to each other in all the test parameters, but were distinctly different from the type strains of the two phenotypically similar species, F. mortiferum and F. varium. High similarity in PCR- and protein-profiles also raise the possibility that all these F. ulcerans strains came from one clone. We noted significant differences among the strains of F. mortiferum and F. varium.

Summarizes the thoughts of Edmund G. (Pat) Brown, former governor of California, on the death penalty and the 36 people he let die while he was in office.

A device is described that consists of two parallel, three-level differential amplitude discriminators suitable for the selection of electrophysiological data. The present device has been designed for simplicity of construction and operation. The unit allows for a visualisation of the selected levels in precise relationship to the input signal oscilloscope channel. The design eliminates the possibility that a lower level will exceed a higher level. The resulting ease with which complex multi-unit electrophysiological data may be discriminated for analysis using the three digital reference level outputs, makes this instrument suitable for a wide range of electrophysiological experiments.

The frequent occurrence of sensorineural hearing loss in patients with chronic renal insufficiency prompted us to study the influence of chronic renal failure upon Na+, K+-ATPase in the inner ear of guinea pigs. Na+, K+-activated ATPase was defined as the ouabain-sensitive part of total ATPase, the activity of which was obtained in the presence of sodium, potassium and magnesium. A significant reduction of Na+, K+-activated ATPase was found in the inner ear of uremic animals. Such inhibition could be demonstrated as early as 12 hours after subtotal nephrectomy. An inverse correlation was found between serum creatinine levels and Na+, K+activated ATPase. A similar inhibition of Na+, K+-activated ATPase in uremia is also found in other tissues (erythrocytes, renal tubules, intestinal mucosal cells, sar-colemma). Na+, K+-ATPase in the cochlea plays a key role in the maintenance of cochlear cationic gradients. It is suggested that inhibition of this enzyme system may contribute to the inner ear dysfunction in uremia.

Glutamic acid decarboxylase (GAD; glutamate decarboxylase, L-glutamate 1-carboxy-lyase, EC 4.1.1.15), which catalyzes formation of gamma-aminobutyric acid from L-glutamic acid, is detectable in different isoforms with distinct electrophoretic and kinetic characteristics. GAD has also been implicated as an autoantigen in the vastly differing autoimmune disease stiff-man syndrome and insulin-dependent diabetes mellitus. Despite the differing GAD isoforms, only one type of GAD cDNA (GAD-1), localized to a syntenic region of chromosome 2, has been isolated from rat, mouse, and cat. Using sequence information from GAD-1 to screen a human pancreatic islet cDNA library, we describe the isolation of an additional GAD cDNA (GAD-2), which was mapped to the short arm of human chromosome 10. Genomic Southern blotting with GAD-2 demonstrated a hybridization pattern different from that detected by GAD-1. GAD-2 recognizes a 5.6-kilobase transcript in both islets and brain, in contrast to GAD-1, which detects a 3.7-kilobase transcript in brain only. The deduced 585-amino acid sequence coded for by GAD-2 shows less than 65% identity to previously published, highly conserved GAD-1 brain sequences, which show greater than 96% deduced amino acid sequence homology among the three species. The function of this additional islet GAD isoform and its importance as an autoantigen in insulin-dependent diabetes remain to be determined.

The release of glandular kallikrein into the interstitium of the parotid gland appears to play an important role in the occurrence of the inflammatory interstitial edema in chronic recurrent parotitis. This provides fresh impetus for the treatment of this parotid disease with a kallikrein inhibitor. In our present study, seven patients with acute exacerbated chronic recurrent parotitis were treated with the kallikrein inhibitor aprotinin (Trasylol, Bayer AG, Leverkusen). With this therapy all patients were free of pain 12 h after the start of the therapy and most salivary gland function had returned to normal by 48 h after beginning treatment. Within this period of time, concomitant swelling of the affected parotid gland disappeared completely in five patients and resolved in the other two patients after 1 week.

Two obese women with thrombotic disease complicated by necrosis of the breast are described. In one patient the reaction started after a few days of coumarin treatment and progressed to severe necrosis requiring mastectomy. The other patient was not on anticoagulant therapy when the breast reaction started and the clinical course was less severe. The radiographic appearance was characterized by thickening of the breast trabeculae, increased density of the breast and skin thickening. Although the radiographic findings are non-specific, the correct diagnosis can be suggested if combined with appropriate clinical information. The disease process may mimic breast cancer of the inflammatory type, clinically as well as radiographically.

A preliminary color-magnitude diagram of the distant open cluster Tombaugh 2 shows it to bear a close resemblance to the well known, metal-poor cluster NGC 2158. From this, it is deduced that To 2 has a reddening of 0.08, a distance modulus of 15.6, and a main sequence turn-off color of 0.27. To 2 is approximately 18.5 kpc from the galactic center, and -1.69 kpc from the galactic plane, therefore representing one of the most distant open clusters from both the galactic plane and center.

Two repetitive DNA fragments located on the mouse X chromosome are described. The fragments were isolated from a lambda phage library enriched in X-chromosomal sequences by flow sorting. Both fragments, which are repeated 20 to 50 times in the genome, were mapped to the mouse X chromosome by Southern blot hybridization to DNA from hybrid cells retaining the mouse X chromosome, by dosage analysis, and by in situ hybridization to mouse chromosomes. In mouse strain C57BL/10BK, one fragment appeared to be located only on the X chromosome, while the other fragment had homologous sequences on chromosome 11 in addition to the X chromosome. The latter fragment showed DNA variants between mouse strains, which are potentially useful for mapping. Both fragments cross-hybridized to another mouse species: Mus caroli. In this species, each fragment appeared to be located on the X chromosome, indicating that some X-chromosome repetitive sequences are partially conserved. In addition, one fragment cross-hybridized to human DNA.

DISCUSSION Torridge Bridge: design; construction EngrsInstn Civ. of structs & Bldgs, 1993,99, substructure and deck precasting work;Feb., 1 0 1 - ~ ~ ~ Papers 9424,9515, erection of superstructure and 9516 PYOC. C. H. Pothecary, T .J. C. Christie and L. Brindle M. R. Hawkins, DevonCountyCouncil The decision to use grand blast-furnace slag in blend to minimize alkali silica reaction brought some difficulties in the casting of the units. Could the Authors say more about this? Have they used this type of mix subsequently? 2...

The results of a fully three-dimensional inviscid compressible calculation technique for the flow field inside centrifugal impellers are compared to optical measurements in an open, radial exit impeller. It is concluded from this comparison that as long as viscous influence, including its displacement effects (manifested mainly in the jetwake flow structure), are not too big, the inviscid method applied can be used with confidence. When the viscous influence is such that it distorts the flow field in certain regions but displacement effects are still insignificant, the inviscid method can be used outside regions of viscous dominance. This situation occurs about halfway downstream, through the impeller. Only when displacement effects resulting from viscous flow field distortions, become big and the jet-wake profile becomes fully developed, does the inviscid method fail to predict the correct flow field. This happens at the exit of the impeller investigated here.

A mathematical model of left ventricular pressure (LVP) during isovolumic contraction in the time domain shows the following predictions: 1) td, the time from onset of contraction to dP/dtmax and (dP/dt)/P, reflect only the time-dependent aspects of contraction, and are independent of preload; 2) dP/dtmax depends on both preload and the time-dependent aspects of contraction. To test preload independence we reduced filling volume (FV) by the method of ventricular volume clamps with a remote-controlled mitral valve in 7 anesthetized open-chest dogs. A decrease in FV of 80±15% produced a 29±12% (p<0.001) decrease in LVP, 34±13% (p<.001) decrease in dP/dtmax, 13±4% (p<0.001) decrease in t-dP/dtneg, and no change in td(-3±5%, NS). The heart rate (HR) dependence on td was assessed in other 5 anesthetized open-chest dogs. HR was changed with atrial pacing (50–240 bpm). td was linearly and inversely related to HR in each dog, and at each HR: dobutamine lowered and propranolol elevated this relation when compared to control (p<.001, both). Since dP/dtmax occurs usually before the opening of the aortic valve, td is, thus, also afterload-independent. Conclusion: This study supports the theoretical predictions that td is independent of preload and that it can serve, at any given HR, as a reliable index of contractility, provided that dP/dtmax occurs before the opening of the aortic valve.

Summary Several mechanical indices predicted from a model of cardiac muscle contraction are tested. In thein-vivo canine heart, dp/dtmax and t-dp/dt, the time, interval from onset of contraction to dp/dtmax, were measured. The product of these parameters Ap=t-dp/dt×dp/dtmax was calculated. t-dp/dt was shortened when heart rate was elevated and remained constant when ventricular end diastolic volume was changed. Ap increased with augmentation of ventricular end diastolic volume. To achieve constant muscle length when heart rate is changed, analogous tension measurements (assigned as dT/dtmax, t-dT/dt and AT) of prestretched Walton Brodie strain-gauge arch had been taken instead of pressure measurements. In the experiments in which Tmax, maximal isometric tension, was not changed for various heart rates, AT was also unchanged. These results are consistent with the predictions that t-dp/dt and Ap can be used as two independent mechanical indices: 1) t-dp/dt for the evaluation of the “time-dependent properties” of contraction and 2) Ap, for the evaluation of the “quantitative properties” of contraction. The advantages of applying these two mechanical indices for use in the intact ejecting heart, instead of the well-established parameters Vmax and Po are emphasized.

DNA-ploidy and the percentage of S-phase fractions in 55 primary oropharyngeal squamous epithelium carcinomas were measured by DNA-Flow Cytometry (FCM). The data were compared with the histologic grade, the stage and the response of the tumours to cytostatic chemotherapy. A significant correlation was found between the histologic grade and the mean percentage of S-phase fractions (p < 0.01). No correlation could be found between the FCM measurement data and the tumour stage. Carcinomas with an amount from 4.0 to 10.4% S-phase fractions responded to chemotherapy by complete remission, and those with 10.0 to 13.3% S-phase fractions by partial remission. The group of non-responders could be subdivided into two subgroups: non-responders with low amounts of S-phase fractions (1.1-3.9%), and non-responders with very high amounts of S-phase fractions (11.6-16.6%). FCM data, histologic and clinical prognostic factors were summed up to a prognostic score. The number of score points showed a significant correlation to the length of survival in months after diagnosis of the tumour (p < 0.00001). FCM may be used as an additional diagnostic tool for a better biological characterization of the neoplastic tissue, especially as an aid for grading, prediction of the response to chemotherapy and the length of survival

A cDNA encoding a new human lymphocyte cell surface molecule has been isolated and shown to identify a fourth member of a recently discovered family of adhesion proteins. This lymphocyte-associated molecule (LAM-1) is uniquely composed of multiple distinct domains, one domain homologous with animal lectins, one homologous with epidermal growth factor, and two short consensus repeat units similar to those found in C3/C4 binding proteins. This cDNA clone hybridized with RNAs found in B cell lines and T lymphocytes, but not with RNA from other cell types. The amino acid sequence of LAM-1 is 77% homologous with the sequence of the mouse lymphocyte homing receptor, suggesting that LAM-1 may function in human lymphocyte adhesion. The LAM-1 gene is located on chromosome 1q23-25, as is another member of this adhesion family, suggesting that this new family of proteins may be encoded by a cluster of "adhesion protein" loci.

Summary The frequence occurence of sensorineural hearing loss in patients with chronic renal insufficiency prompted us to study the influence of chronic renal failure upon Na+-K+-ATPase in the inner ear of guinea pigs. Na+-K+-activated ATPase was measured as the difference between total ATPase (in the presence of Na+-K+) and basal ATPase (inhibition by ouabain). A significant reduction of Na+-K+-activated ATPase (given as fraction of total ATPase) was found in the inner ear. Such inhibition could be demonstrated even 12 h after subtotal nephrectomy. An inverse correlation was found between serum creatinine levels and Na+-K+-activated ATPase. A similar inhibition of Na+-K+-activated ATPase in uremia is also found in other tissues (erythrocytes, renal tubules, intestinal mucosal cells, sarcolemma). Na+-K+-ATPase in the cochlea plays a key role in the maintenance of cochlear cationic gradients. It is suggested that inhibition of this enzyme system may contribute to the inner ear dysfunction in uremia.

Conflicting reports have been presented with respect to inner ear function of renal patients. Therefore, a detailed analysis of inner ear function was performed in patients of the Heidelberg Dialysis and Transplantation Program.

A perfusion system was designed for the purpose of conserving reagents and/or limiting the quantities of hazardous materials generated during in vitro electrophysiological experiments. The apparatus consisted of a stirred cell assembly and an appropriate size-exclusion filter to combine a recirculating flow with a continuous flow of substance-free solution. The system was able to achieve a rapid exchange of solution in the recording chamber without loss of the high molecular weight test substances, botulinum toxin B or an IgG immunocomplex, over a 4-h period of perfusion. Selective filtration was accomplished by directing a continuous influx of fresh solution to the stirred cell to clear low molecular weight components, while incorporating a 100-kDa cutoff filter in the efflux-towaste flow to retain the desired high molecular weight substances. Adsorption of these substances to the filter and assembly was minimized by use of a low protein binding filter and inclusion of 0.1 mg / mL bovine serum albumen.

Twenty-five patients who had undergone renal transplants developed uncommon complications that were detected and followed serially with sonography. Two patients developed renal calculi, which produced hydronephrosis in both instances. Other uncommon causes of postoperative hydronephrosis occurred in 5 cases; the causes included ureteral necrosis, ureteral stricture, and a renocutaneous fistula. Eight cases of renal infarction, manifesting 3 different sonographic appearances, were encountered. The presence and disappearance of postoperative gas in the collecting system were documented in 3 patients. The other unusual abnormalities detected involving the transplanted kidney include tuberculosis, pyonephrosis, 3 solitary cysts, a corpus lutem cyst simulating a perinephric fluid collection, and massive urinary ascites.

ZFX, an X chromosome-linked gene encoding a zinc-finger protein, has previously been shown to escape X inactivation in humans. Here we report studies of the inactivation status of the homolog, Zfx, on the mouse X chromosome. We took advantage of both the preferential inactivation of the normal X chromosome in females carrying the T(X;16)16H translocation and the high degree of nucleotide sequence variation between the laboratory strain of mouse [corrected] and Mus spretus genomes. An EcoRV restriction fragment difference between laboratory strain of mouse [corrected] and M. spretus was detected after amplification of Zfx transcripts using the reverse transcription-polymerase chain reaction. Using this allelic variation, we assessed expression of the two Zfx genes in females carrying the T(X;16)16H translocation (from laboratory strain of mouse [corrected]) and an intact X chromosome (from M. spretus). Such females exhibit Zfx transcription from the active laboratory strain of mouse [corrected] chromosome but not from the inactive M. spretus chromosome. These results indicate that the mouse Zfx gene is subject to X inactivation.

Recent developments in internal viscous aerodynamics of centrifugal impellers and related flows are critically reviewed. The overall picture which emerges provides the reader with a state-of-the-art perspective on the subject. Gaps in understanding are identified to stimulate future research. Topics included in this review are: experimental work carried out in the last decade, the structure of turbulence in curved rotating passages and solution of viscous flow problems in impellers.

Recent developments in inviscid prediction methods of internal flow fields of centrifugal impellers and related flows are critically reviewed. The overall picture which emerges provides the reader with a state-of-the-art perspective on the subject. Restricting simplifying assumptions of the various methods are identified to stimulate future research. Topics included in this review are: two-dimensional subsonic and transonic inviscid flows as well as three-dimensional inviscid flows.

The puzzles of the magnitude of the free-electron mobility and the sign of the effective correlation energy of the dangling-bond defect in hydrogenated amorphous silicon are examined. It is suggested that the existence of a negative effective correlation energy in the less-strained regions of the material can resolve the apparently contradictory results for the magnitude of the band mobility. The internal fields arising from the presence of positively and negatively charged dangling bonds can be neutralized under high-level double-injection conditions, effectively increasing the mobility by more than an order of magnitude. We present experimental results that are consistent with the hypothesis.

Silicon thin films prepared by chemical vapor deposition of silane at very low pressures (4 mTorr) in an experimental reactor that allows deposition with and without plasma enhancement have been characterized. The temperature range of the substrates on which the films were deposited was varied from 500 to 800° C for plasma-enhanced depositions and 600 to 800° C for nonplasma depositions. Conductivity measurements as a function of temperature as well as average grain size and crystallographic texture measurements were performed. The results indicate that the films deposited with the assistance of a plasma were amorphous at deposition temperatures of 650° C and below and polycrystalline at deposition temperatures of 700° C and above. In the temperature regime investigated, this amorphous-to-crystalline transition was not observed in films deposited without the assistance of a plasma. Furthermore, all the films deposited at temperatures of 650° C and below have been found to have significantly different properties from the similarly prepared films deposited at higher temperatures.

Recounts the story of 17-year Los Angeles police officer William E. Leasure, who along with Robert Kuns stole between 11 and 20 yachts in California between 1983 and 1986, and resold them. Dennis France, 44, and others linked Leasure to three contract murders. Questions; Trials of those involved.

Discusses whether Barry Diller, chairman and chief executive officer of 20th Century Fox, may be putting so much energy into his struggling `fourth network' to the detriment of the rest of the movie studio.

Profile. In the last five years, this Denver oilman has picked up and dumped two of Los Angeles' most legendary institutions, the Beverly Hills Hotel and the Fox Plaza. An analysis of his plans for Los Angeles investments. INSET: What Marvin Davis has done with the Beverly Hills Hotel..

How new President Bill Kobin saved Los Angeles public television station KCET from a $5 million economic downslide. Profiles Kobin's career and how he initiated better programming and fund-raising for KCET. INSET: History of KCET..

Profiles Jackie Robinson, the first black man to play modern-day major league baseball. His childhood; Outstanding high school and college athlete; Why he was court-martialed during World War II; How he became a Brooklyn Dodgers baseball player with help from team president Branch Rickey; Endured racial incidents during his career; Career highlights; Busy retirement.

Conductance measurements are presented for junctions of the type metal-oxide-amorphous silicon, where the oxide is sufficiently thin to permit tunnelling. The conductance exhibits a temperature dependence essentially identical to that for amorphous silicon with no oxide barrier present, but is several orders of magnitude smaller. A simple model, which assumes tunnelling into localized states as the dominant conduction process, is proposed to account for the temperature dependence. Using this model, an appropriate density of states in the vicinity of the Fermi level is obtained for amorphous silicon.

Transport measurements have been performed on the conducting state of a memory-type chalcogenide glass, of composition Te81Ge15As4. DC resistivity was measured from 4°K to 300°K and indicates no carrier freeze-out occurs down to 4°K. The resistance ratio, ϱ(300°K)/ϱ(4°K), was found to be 2.5. AC conductivity measurements at room temperature showed only an 18% increase in σ(ω) up to 150 khz. Hall effect experiments at 100 Hz show no dependence of carrier concentration on temperature from 77°K to 300°K, and indicate a room temperature mobility of 85 cm2/V-sec. The sign of the Hall constant implies that the carriers are holes. Resistance was measured as a function of magnetic field from 0 to 140 kOe, at 1.6°K. The magnetoresistance was positive and proportional to H2at low fields, with saturation beginning to set in above about 80 kOe. The results of these studies, taken in conjunction with the X-ray and NMR data, can be used to suggest a plausible model for memory behavior in chalcogenide glasses.

Summary 1. The pulmonary hyaline membranes of the adult are much more common than admitted so far. In 42 of 833 autopsies (5%) performed after the 7th day of life (end of the perinatal period), more or less extensive hyaline membranes have been observed in one or more lobes.