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Zusammenfassung: Hintergrund: Eine neoadjuvante Bestrahlung des Ösophagus bei fortgeschrittenem Ösophaguskarzinom führt häufig zur Schädigung der üblichen Anschlussgefäße freier Gewebetransfers. Eine Alternative bietet die End-zu-Seit-Anastomosierung an die A. carotis communis. Patienten und Methoden: Insgesamt 70 Patienten mit einem lokal fortgeschrittenen Plattenepithelkarzinom des zervikalen Ösophagus wurden nach neoadjuvanter Radiochemotherapie limitiert ösophagektomiert und mit einem freien Jejunumtransplantat rekonstruiert. In 54 Fällen gelang der arterielle Anschluss an Abgangsgefäße der A. carotis externa oder des Truncus thyrocervicalis, während bei 16 Patienten aufgrund der lokalen Strahlenschädigung ein Anschluss an die A. carotis communis erfolgte. Ergebnisse: Nach Anschluss an die A. carotis communis sahen wir keine behandlungsbedürftigen Durchblutungsstörungen. 9 von 54 Patienten (17%) mit mikrovaskulären Anastomosen an die kleineren Halsgefäße erforderten Revisionen zum Erhalt der Lappenperfusion. Schlussfolgerung: Der Anschluss an die A. carotis communis stellt auch bei vorübergehender Umgehung des originären Kreislaufs mittels Javid-Shunt eine sichere Methode zum freien Gewebetransfer dar.

It appears that among patients with definite primary Sjogren's syndrome (DSS) or probable SS (PSS) many have silent and symptom-free heart conditions. Doctors evaluated echocardiograms and pressure measurements of 54 patients with DSS, 10 patients with PSS and 21 healthy volunteers (the control group). The pericardium, or sac that surrounds the heart, was thickened in 33% of the 64 study patients and none of the control group. Study patients had higher calculated lung pressure values and lower diastolic blood pressure measurements than the control group.

Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis.

Observers are essential in artificial pancreas systems, either for states or disturbance estimation. Kalman filters based on the Hovorka model are largely applied for this purpose. However, simpler approaches can be used too. We intend to analyze whether the observer structure, the applied model and the individualization of the model parameters affect the estimation accuracy. We perform an in-silico comparison between two Kalman filters and a sliding mode observer, as observer structures previously proposed in the field. All observers are implemented in population and individualized versions of the Hovorka and the simpler Identifiable Virtual Patient models. To tune the Kalman filters, a genetic algorithm based framework was developed. The results indicate that the choice of the model has a larger effect on the outcome than the choice of the observer structure. Finally, the observer based on the Hovorka model does not always perform the most accurate estimation given the higher difficulty during the identification of its parameters.

Recently, a comprehensive study was published on HLA class II DNA typing in a large cohort of European patients with SLE. (1) Independently of this collaborative study, we have examined [...]

Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown.

The family of cisplatin and its analogues contains some of the most powerful anticancer drugs developed to date and, since their discovery, extensive efforts have been devoted to understand their mode of action. 9-Alkylguanines have featured widely in these studies as model nucleobases. This review describes both the synthesis and the chemical, biological and miscellaneous spectroscopic properties of a variety of transition metal ion (Pt, Pd, Ru, Os, Rh, Re, Tc, Zn, Cu, Cd) complexes of N-alkylguanines (mostly 9- alkylguanines) which have been reported in the literature principally within the 2003-2008 period. Special attention has been given to the acid-base properties of these complexes, where coordination to transition metal ions usually leads to significant acidification of the guaninyl N1-H proton, and its consequences

The synthesis, chemical, physical, biological, spectroscopic and miscellaneous analytical properties of Nalkylguanine derivatives substituted at 1-, 1,N²-, N2-, 3-, 3,N2-, 7-, 7,9- and 9-positions have been surveyed, mainly from the 2003-2009 period. Beyond the synthetic methods, particular emphasis has been given to products of mutagenesis and carcinogenesis, the role of modified fluorescent guanosines (wyosine, wyebutosine), mRNA cap structures and drugs stemming from N-alkylguanines. The review is based on 154 references and contains 64 schemes with 355 numbered structures.

Es gibt heute eine Vielzahl von Methoden, die weibliche Brust nach Mastektomie zu rekonstruieren. In dieser Studie wurde die Lebensqualität der Patientinnen und die Zufriedenheit mit dem Operationsergebnis untersucht. Zwei häufig angewendete Operationsmethoden wurden dabei miteinander verglichen (Eigengewebe vs. Expander/Implantat).Es konnten 91 Patientinnen, bei denen zwischen 1996 und 2001 im Klinikum rechts der Isar eine Brustrekonstruktion erfolgt war, in unsere Studie einbezogen werden. Lebensqualität und Zufriedenheit mit dem Operationsergebnis wurden retrospektiv anhand von Fragebögen erfasst.Die Operationsergebnisse nach Eigengewebsrekonstruktion wurden generell besser bewertet. Der Unterschied war in folgenden Bereichen signifikant: Größe der Brust, Form, Abgrenzbarkeit der Unterbrustfalte, Gewebebeschaffenheit und Symmetrie der Brüste. Mindestens zwei Jahre nach der Brustrekonstruktion entsprach die Lebensqualität unserer Patientinnen in beiden Gruppen der von gesunden Frauen der gleichen Altersgruppe.Obwohl die Ergebnisse nach Eigengewebsrekonstruktion besser bewertet wurden, hatte die Wahl des Operationsverfahrens keinen Einfluss auf die Lebensqualität.Nowadays, the array of methods for reconstruction of the female breast following mastectomy is vast. In this study, we investigate and compare quality of life after breast reconstruction and satisfaction with the results of two commonly used techniques (autologous tissue vs. expander/implant).Ninety-one consecutive patients who underwent breast reconstruction at a German clinic between 1996 and 2001 were included in the study. Patient satisfaction and quality of life were assessed retrospectively using self-evaluation questionnaires.Patients were generally more satisfied with the outcome of the operation when autologous tissue was used. This was significant in the following areas: breast size, form, definition of the lower breast fold, softness of the breast, and symmetry of the breasts. In both groups the quality of life following breast reconstruction at least 2 years after the operation was equal to that of healthy women of the same age group.Although patients were more satisfied with the results of autologous breast reconstruction, procedure choice did not affect quality of life.

In der Medizin wird die Erfassung der Lebenszufriedenheit zunehmend als Zielkriterium in der Evaluation von medizinischen Maßnahmen eingesetzt. Bisher liegen nur ganz vereinzelt Untersuchungen zur Lebenszufriedenheit bei Transsexuellen (TS) vor. Ziel unserer Studie war es daher, die „Allgemeine Lebenszufriedenheit“ und die „Zufriedenheit mit der Gesundheit“ bei Transsexuellen postoperativ zu untersuchen.An der Querschnittsstudie nahmen 40 transsexuelle Patienten teil. Als Messinstrument verwendeten wir die „Fragen zur LebenszufriedenheitModule“ (FLZM) und freie Fragen zu verschiedenen Aspekten der neuen Geschlechtsidentität.Mit dem Ergebnis der Angleichungsoperation bzw. der neuen Geschlechtsidentität zeigten sich 85–95% der TS „sehr zufrieden“ bzw. „zufrieden“. Im Summenscore des FLZM-Moduls „Allgemeine Lebenszufriedenheit“ waren die TS jedoch signifikant (p<0,001) unzufriedener als die Durchschnittsbevölkerung, im Summenscore des Moduls „Gesundheit“ ergaben sich keine Unterschiede.Diese Daten weisen auf eine Diskrepanz zwischen subjektiver Zufriedenheit mit der neuen Geschlechtsidentität und der aktuellen Lebenssituation hin und zeigen somit Probleme in der Lebenszufriedenheit auf.More and more frequently, the registration of life satisfaction is being used to evaluate different medical treatments. So far, there have been only few such surveys on transsexuals (TS). Therefore, the aim of this study was to evaluate the general and the health-related life satisfaction of transsexuals after gender transformation operations.Forty patients took part in this German cross-sectional study. The Questions on Life Satisfaction Module (FLZ) and free questions on different aspects of the new gender identity were used as measuring instruments.Of the TS studied, 85–95% were “very satisfied” or “satisfied” with the results of their gender transformation operation in respect to gender identity. The TS were significantly less satisfied (P>0.001) in overall “general life satisfaction” than the general population. In overall FLZ scores for “health-related life satisfaction”, no differences were seen.These data indicate a discrepancy between subjective satisfaction with new gender identity and current life situation, and they identify problems with life satisfaction.

Zusammenfassung Das Merkmal der fetalen Wundheilung ist die narbenlose Heilung einer Wunde im frühen Gestationsalter. In den letzten 20 Jahren galt das Interesse der Forscher aus den verschiedensten Fachrichtungen den molekularen Regulationsmechanismen, die dem Phänomen der narbenlosen Wundheilung zugrunde liegen. Mit besserem Einblick in die zeitlich genau abgestimmten Abbau- und Synthesereaktionen können zukünftig wichtige Therapieoptionen zur Prävention und Reduktion der Narbenbildung nach chirurgischen Eingriffen und Traumen entwickelt werden. Ziel dieser Arbeit ist es, einen Überblick über die bedeutendsten Arbeiten der letzten 2 Jahrzehnte auf dem Gebiet der fetalen Wundheilung zu geben. Es soll auch auf die—aus dem fetalen Wundheilungsmodell entwickelten—Behandlungsansätze zur Modulation der adulten Narbenbildung eingegangen werden. Die bisher experimentell erzielten Ergebnisse unter Verwendung dieser neuen Therapieoptionen sind äußerst viel versprechend und richtungsweisend und stellen eine enorme Chance für die Chirurgie der Zukunft dar.

The formation of adsorbed surfactant layers consisting of a mesh or network of branched cylindrical aggregates on muscovite mica by several surfactant systems is described. The curvature of the adsorbed aggregates is varied by a variety of mechanisms that all generate morphologies between adsorbed cylinders and bilayers, and the resulting lateral structure is imaged by “soft contact” atomic force microscopy. We compare the direct images and Fourier transforms of the adsorbed layer structures, and relate them to those formed in bulk solution.

Adsolubilization of naphthalene, 1-naphthol, and 2-naphthol is demonstrated by atomic force microscopy imaging to cause changes in the adsorbed layer structure of quaternary ammonium surfactants at the mica/aqueous solution interface. Surface compositions for both surfactants and additives, derived from HPLC measurements of solution depletion, support the existence of shape transitions and of nonideal effects in the adsolubilization of these solutes.

d-Gluco- and d-xylopyranosylidene-spiro-hydantoins and -thiohydantoins were prepared from the parent sugars in a six-step, highly chemo-, regio-, and stereoselective procedure. In the key step of the syntheses C-(1-bromo-1-deoxy-β-d-glycopyranosyl)formamides were reacted with cyanate ion to give spiro-hydantoins with a retained configuration at the anomeric center as the major products. On the other hand, thiocyanate ions gave spiro-thiohydantoins with an inverted anomeric carbon as the only products. On the basis of radical inhibition studies, a mechanistic rationale was proposed to explain this unique stereoselectivity and the formation of C-(1-hydroxy-β-d-glycopyranosyl)formamides as byproducts. Enzyme assays with a and b forms of muscle and liver glycogen phosphorylases showed spiro-hydantoin 12 and spiro-thiohydantoin 14 to be the best and equipotent inhibitors with Ki values in the low micromolar range. The study of epimeric pairs of d-gluco and d-xylo configurated spiro-hydantoins and N-(d-glucopyranosyl)amides corroborated the role of specific hydrogen bridges in binding the inhibitors to the enzyme.

Objective. Patients characterized with antinuclear antibodies (ANA) and disease symptoms related to one organ system can be described as having incomplete systemic lupus erythematosus (SLE). The aim of this multicentre study was to describe the outcome of these so‐called incomplete SLE patients. Two aspects of the outcome were studied: (i) the disease course, defined by the presence or absence of clinical symptoms; and (ii) the number of patients that eventually developed full SLE.Methods. Outcome parameters were the ACR criteria, the SLE disease Activity Index (SLEDAI), the European Consensus Lupus Activity Measure (ECLAM) and the requirement for treatment. In 10 European rheumatology centres, patients who had been evaluated in the last 3 months of 1994 and had been diagnosed as having incomplete SLE on clinical grounds for at least 1 yr were included in the study. All 122 patients who were included in the study were evaluated annually during 3 yr of follow‐up.Results. Our results are confined to a patient cohort defined by disease duration of at least 1 yr, being under clinical care at the different centres in Europe. These patients showed disease activity that was related mostly to symptoms of the skin and the musculoskeletal system, and leucocytopenia. During the follow‐up, low doses of prednisolone were still being prescribed in 43% of the patients. On recruitment to the study, 22 of the 122 incomplete SLE patients already fulfilled the ACR criteria for the diagnosis of SLE. In the 3 yr of follow‐up only three patients developed SLE.Conclusions. A high proportion of patients in our cohort defined on clinical grounds as having incomplete SLE eventually showed disease activity defined by the SLEDAI as well as ECLAM. However, only three cases developed to SLE during the follow‐up. This suggests that incomplete SLE forms a subgroup of SLE that has a good prognosis.

This article reviews the spectroscopic properties of hydrogen bound to a large variety of synthetic compounds like simple oxides, perovskites, the LiNbO3 family, KTP, sillenites, eulytites, borates, garnets, spinels and some others. In almost all compounds the OH stretch mode is found in the range 3200-3700 cm-1, with isotope replica of deuterium (2350-2750 cm-1) and a few examples of tritium (2050-2250 cm-1). The fundamental vibration, the isotope replica and the corresponding overtones are described with an anharmonic oscillator model. A nonlinear relation between the anharmonicity and the harmonic frequency is found and interpreted using recent second order perturbation calculations. An often pronounced temperature dependence of the stretch mode and phonon coupling is discussed. Data for the stretching vibration influenced by additional weak or strong doping are presented. Atomistic defect models are described and tested by means of light polarization, external perturbations like pressure and electric field, and Raman scattering analyzed with the behavior-type method. The last section briefly reviews applications profiting from doping with hydrogen and its easy detection by means of the OH stretch mode.

Objective. Most information available about the disease course of patients with systemic lupus erythematosus (SLE) is restricted to the first 5 yr after disease onset. Data about the disease course 10 yr after disease onset are rare. The aim of this multicentre study was to describe the outcome of SLE patients with a disease duration of >10 yr.Methods. Outcome parameters were the SLE Disease Activity Index (SLEDAI), the European Consensus Lupus Activity Measure (ECLAM), the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR), a global damage index (DI) and required treatment. In 10 different European rheumatology centres, all SLE patients who were evaluated in the last 3 months of 1994, and who had been diagnosed with SLE at least 10 yr ago, were included in the study.Results. It should be stressed that our results are confined to a patient cohort, defined by a disease duration of at least 10 yr, and who are still under clinical care at the different centres in Europe. These SLE patients still showed some disease activity, related to symptoms of the skin and musculoskeletal systems, next to the presence of renal involvement. A total of 72% of the patients needed treatment with prednisolone (≤7.5 mg). The cumulative damage was overall related to clinical features of the central nervous system (14%) and renal involvement (14%), next to deforming arthritis (14%), osteoporosis (15%) and hypertension (40%). The prevalences of obesity, Cushing appearance and diabetes are highly suggestive that the ongoing treatment and that in the past might have had an impact on the total sum of end-organ damage.Conclusions. After 10 yr, a high proportion of patients in our cohort continued to show evidence of active disease, defined by the SLEDAI as well as ECLAM. The DI was related to the involvement of the central nervous system, renal involvement and the presence of hypertension.

1Inactivation and recovery kinetics of L‐type calcium currents were measured in myotubes derived from satellite cells of human skeletal muscle using the whole cell patch clamp technique.2The time course of inactivation at potentials above the activation threshold was obtained from the decay of the current during 15 s depolarizing pulses. At subthreshold potentials, prepulses of different durations, followed by +20 mV test pulses, were used. The time course could be well described by single exponential functions of time. The time constant decreased from 17.8 ± 7.5 s at ‐30 mV to 1.78 ± 0.15 s at +50 mV.3Restoration from inactivation caused by 15 s depolarization to +20 mV was slowed by depolarization in the restoration interval. The time constant increased from 1.11 ± 0.17 s at ‐90 mV to 7.57 ± 2.54 s at ‐10 mV.4Restoration showed different kinetics depending on the duration of the conditioning depolarization. While the time constant was similar at restoration potentials of ‐90 and ‐50 mV after a 1 s conditioning prepulse, it increased with increasing prepulse duration at ‐50 mV and decreased at ‐90 mV.5The experiments showed that the rates of inactivation and restoration of the L‐type calcium current in human myotubes were not identical when observed at the same potential. The results indicate the presence of more than one inactivated state and point to different voltage‐dependent pathways for inactivation and restoration.

ABSTRACT: Thirteen women during the 5th and 6th weeks of gestation were treated with a progesterone receptor blocker (ZK 98734) for pregnancy termination. Five patients received 100 mg/day of the compound, and eight patients received 50 mg/ day for 4 days. Daily blood samples were obtained during the treatment period as well as on days 8 and 15 after the beginning of drug administration, and cytotoxic activity, progesterone sensitivity, and progesterone binding capacity of the lymphocytes were determined. Determination of SP‐1 concentrations monitored the saturation state of trophoblastic progesterone receptors.

Among the countries in Central and Eastern Europe, Hungary has a high oral contraceptive prevalence rate. Until recently, however, Hungarian women have not had access to combined oral contraceptives with new, third-generation progestogens. Marvelon (30 μg ethinylestradiol and 150 μg desogestrel) was first introduced in 1981 in Western Europe and has, in a number of different studies, proven an effective and well-tolerated oral contraceptive with no effect on blood pressure and a favorable lipid profile. Marvelon was introduced in Hungary in October 1991. Prior to its introduction, a multicenter study was undertaken in Hungary with Marvelon to confirm the clinical results of studies from other countries. The present study confirmed Marvelon to be an effective, welltolerated combined oral contraceptive with no relevant effect on blood pressure. Remarkable improvements were noted, especially with regard to side-effects, in switchers from other oral contraceptives. It is concluded that Marvelon is a valuable extension of the range of contraceptive methods available in Hungary.

Endogenous hyperprolactinaemia induced by anterior pituitary transplantation under the kidney capsule has been found to reduce the behavioural responsiveness to electrical footshock and to increase morphine-induced analgesia. The apparent analgesic effect of prolactin has been related to the stimulation of nigro-striatal dopaminergic transmission, as suggested by the increase in striatal dopamine turnover observed in hyperprolactinaemic rats. It seems likely that central opiate system is involved in the behavioural effects of prolactin. Thus, naloxone prevents the effects of hyperprolactinaemia on footshock responsiveness and heroin self-administration is decreased in hyperprolactinaemic rats.Il a été remarqué que l'hyperprolactinémie causée per la greffe de l'hypophyse antérieure sous la capsule rénale réduit la réponse comportamentale au footshock électrique et augmente l'analgésie produite par la morphine. L'effet analgésique apparent de la prolactine a été mis en relation avec le stimulus de la transmission dopaminergique nigro-striée, comme il est suggéré par l'augmentation du turnover de la dopamine striée chez les rats hyperprolac-tinémiques. Il est probable que le système central opioide joue un rôle dans les effets comportamentaux de la prolactine. Le naloxone est donc à même de prévenir les effets de l'hyperprolactinémie sur la réponse au footshock et de réduire l'autoadministration de l'héroine chez les rats hyperprolactinémiques.L'iperprolattinemia indotta da trapianto di ipofisi anteriore sotto la capsula renale è nota ridurre la risposta comportamentale al footshock elettrico e l'analgesia indotta da morfina. Questo apparente effetto analgesico della prolattina è stato messo in rapporto con la stimolazione della trasmissione dopaminergica nigro-striatale, come suggerito dall'incremento del turnover di dopamina striatale osservato in ratti iperprolattinemici. Sembra quindi verosimile che il sistema oppioide centrale sia coinvolto negli effetti comportamentali della prolattina. Il naloxone peraltro è in grado di prevenire gli effetti della iperprolattinemia sulla risposta al footshock come di ridurre l'autosomministrazione di eroina nei ratti iperprolattinemici.

1. The two calcium indicators Antipyrylazo III (AP III) and Fura‐2 were used simultaneously to monitor free myoplasmic [Ca2+] in voltage‐clamped cut segments of frog skeletal muscle fibres (8‐10 degrees C). Antipyrylazo III was used for the relatively large [Ca2+] transients during 100‐200 ms depolarizing pulses to ‐20 to 0 mV and for the rapid decline of [Ca2+] during the 200 ms after the pulses. Fura‐2 was used to follow the slow decline of the small remaining elevation of [Ca2+] during the following 16 s (slow recovery period) and to monitor resting [Ca2+]. 2. From 1 to 16 s of the slow recovery period [Ca2+] declined with two exponential components, having time constants of 1.9 +/‐ 0.3 and 13.5 +/‐ 1.5 s (these and all other values are means +/‐ S.E.M. of eleven runs from seven fibres). At 1.2 s after the end of the pulses the amplitudes of the fast and slow exponential components of decline of [Ca2+] were 34 +/‐ 7 and 31 +/‐ 4 nM, respectively. The resting [Ca2+] in these runs was 40 +/‐ 4 nM. 3. The time course of calcium bound to parvalbumin [( Ca‐Parv]) was calculated from the [Ca2+] records using literature values for the parvalbumin kinetic constants. From 1 to 16 s of the slow recovery period the total calcium [Ca]T outside the sarcoplasmic reticulum (SR) was assumed to equal [Ca‐Parv] + [Ca‐Fura]. During this period [Ca]T declined with two exponential components having time constants of 1.7 +/‐ 0.2 and 14.2 +/‐ 1.4 s, the same as those for [Ca2+]. Assuming the total concentration of parvalbumin cation binding sites to be 1000 microM, the fast and slow components of [Ca]T had amplitudes of 117 +/‐ 21 and 147 +/‐ 16 microM, respectively, at 1.2 s after the pulses. 4. The rate of decline of [Ca]T, ‐d[Ca]T/dt, was used as a measure of the net rate of removal of calcium from the myoplasm by the SR. From 3 to 16 s of the slow recovery period and in the resting fibre ‐d[Ca]T/dt varied with [Ca2+] according to A[Ca2+]n‐L. The term A[Ca2+]n represents the pump rate and L represents a constant rate of calcium leak from the SR. 5. For 40 nM less than or equal to [Ca2+] less than or equal to 80 nM, the power n for the [Ca2+] dependence of pump rate was 3.9 +/‐ 0.6.(ABSTRACT TRUNCATED AT 400 WORDS)

It has been shown that the antiprogestin RU 486 (mifepristone) increases the sensitivity of the early pregnant human uterus to the stimulatory action of synthetic prostaglandin E (PGE) analogues. To examine if RU 486 also increases uterine sensitivity to the naturally occurring PGE2 given orally, two investigative approaches were used in the present studies: (i) direct registration of uterine contractions before and after PGE2 administration in untreated and RU 486-treated early pregnant women; and (ii) a double-blind, randomized, controlled efficacy trial involving treatment of pregnant women (amenorrhoea of less than or equal to 49 days) with RU 486 (25 mg twice daily for 4 days) and PGE2 (1 mg once or twice) or placebo on the last day of RU 486 treatment. The results indicate that oral PGE2 at the doses employed had little or no stimulatory effect on uterine contractility and that it did not improve the rate of complete abortion achieved with RU 486 alone. Overall, 25 of 42 women (59%) had a complete abortion, 15 women (36%) did not abort and the remaining two had incomplete abortions. Women with complete abortions had significantly lower pretreatment levels of progesterone and a longer duration of induced bleeding than those who did not abort. Thus oral PGE2, when given in clinically acceptable doses, is not a suitable alternative to synthetic PGE analogues for use in combination with RU 486 for termination of early pregnancy.

A multi-centre, randomized trial was conducted to compare the efficacy and side-effects of two combination regimens of the antiprogestin RU 486 and the intramuscular PGE2 analogue sulprostone for termination of early pregnancy (amenorrhoea up to 49 days). Women in the 3-day group (n = 125) received 25 mg RU 486 twice daily for 3 days plus a single injection of 0.25 mg sulprostone in the morning of the third day of antiprogestin treatment. In the 4-day group (n = 126), RU 486 was given for 4 days and the sulprostone injection in the morning of the fourth day. Treatment outcome in the two groups was similar. Overall, 88.8% had a complete abortion, 6.8% an incomplete abortion and 2.4% were treatment failures; in the remaining 2% treatment outcome could not be determined. Only three of the six women with treatment failure still had detectable fetal heart activity when the pregnancy was terminated by vacuum aspiration two weeks after the start of treatment. Five of the 17 interventions for incomplete abortion were carried out as emergency procedures because of heavy bleeding; two of these five women were given a blood transfusion. The majority of the curettages (10/17) were performed in one centre. If the data from this centre and the women with undetermined treatment outcome were excluded, the rates for complete abortion, incomplete abortion and treatment failure in the remaining six centres were 93.6, 3.7 and 2.7%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Ten patients with active acromegaly were studied. In 9 plasma GH levels failed to suppress after glucose (OGTT), in 8 an increase in serum GH occurred after thyrotrophin releasing hormone (TRH). After L-Dopa, 4 patients showed no change in serum GH, 3 exhibited a decrease and in 3 an increase in serum hGH occurred. With a combined insulin (ITT) and arginine (ATT) test, 2 patients exhibited an increase in hGH, and in 6 no change occurred. Fasting serum GH concentration was less than 11 ng/ml in 5 patients. Basal prolactin (hPRL) levels were normal in all patients including two with galactorrhea. L-Dopa suppressed and TRH stimulated hPRL secretion in all, but the responses which were seen were subnormal. Hydrocortisone infusion in two acromegalics did not affect the prolactin induced increase after TRH but blunted the GH increase after TRH.

Myoplasmic free calcium transients were monitored with the metallochromic indicator dye Antipyrylazo III (AP III) in single frog skeletal muscle fibres cut at both ends, stretched so as to minimize or eliminate contractile filament overlap and voltage clamped using a double‐Vaseline‐gap system (approximately 6 degrees C). The dye entered the central fibre segment by diffusion from the solution applied to the two cut ends. The diffusion coefficient of AP III was about 20 times lower in the fibre than in solution. This very slow diffusion was not due to binding of dye since the ratio of bound to free dye obtained from analysis of the diffusion was only about 0.45. For a given depolarizing pulse, the ratio of dye‐related absorbance changes delta A at 720 and 550 nm was the same as that produced on adding calcium to dye in calibrating solution, indicating that these signals were due to changes in myoplasmic calcium. The delta A signals at 700 or 720 nm were used to monitor transient changes in concentration of calcium‐dye complex [CaD2] and of free calcium [Ca] in the myofilament space. By applying the same pulse at different times during dye entry, it was observed that increasing dye concentrations [D]T produced the following effects: (a) [CaD2] was increased; (b) [Ca] was decreased at early times during a pulse; (c) a declining phase of [Ca] observed at late times during pulses was decreased and finally reversed to a slow rising phase at high [D]T; (d) the decay of [Ca] after the pulse was slowed. Analyses of the effects of [D]T on (a) the magnitude of [CaD2] at a given early time during the calcium release produced by pulses to a given voltage and on (b) the time constant for [Ca] decay after a pulse were both consistent with a calcium: dye stoichiometry of 1:2 in the fibre as found in calibrating solution. Analysis of the effect of [D]T on the [Ca] decay time constants also revealed the presence of intrinsic rapidly equilibrating myoplasmic calcium binding sites and provided the basis for obtaining estimates of the combined concentration [Ca] of free calcium plus calcium bound to such sites. Unlike the estimates of [Ca], these estimates of [Ca] are independent of the value of the calcium‐dye dissociation constant.(ABSTRACT TRUNCATED AT 400 WORDS)

Male F-344 rats were treated with CCl4 (0.2 mL/kg three times a week) and phenobarbital (0.2 g/L in drinking water) for 12 weeks. A group of animals received an additional treatment with kappa-carrageenan (5 mg/animal intraperitoneally on days 21, 49, and 77 of the experiment). Liver cirrhosis developed after both kinds of treatment by the end of the 12th week. Six weeks after the termination of the treatment the amount of liver collagen (measured by morphometry and by dye elution) decreased significantly in the CC4 and phenobarbital-treated group, but not in the animals that also received carrageenan. An important role for macrophages in the degradation and resorption of collagen is emphasized. Carrageenan supplementation of CCl4 and phenobarbital treatment may provide a good experimental model of non-regressing liver cirrhosis. Caution is advised regarding carrageenan intake for humans with any preexisting liver damage.

OBJECTIVE: To evaluate the renin-aldosterone system and insulin secretion in hyperparathyroidism and their effects on blood pressure regulation. DESIGN: Studies were carried out on patients with primary hyperparathyroidism (PHPT) prior to and following removal of the parathyroid tumor. METHODS: Sixteen normotensive and euglycemic patients with PHPT were studied. The following parameters were measured: basal and stimulated plasma renin activity (PRA) and aldosterone (ALD) secretion: parathormone (PTH) and serum electrolytes. Insulin and glucose levels were measured during an oral glucose tolerance test. RESULTS: Systolic but not diastolic blood pressure showed a decrease following surgery, from 123.3+/-13.0/80+/-8.6 to 116.7+/-13.5/77.3+/-8.8 mmHg. The decrease in the systolic pressure was not clinically significant. After surgery, both the basal and stimulated PRA and ALD values decreased, and the preoperative pathological values returned to normal: PRA basal: 1.79 --> 0.70 ng/ml/h, P=0.0049; PRA stimulated: 7.76 --> 1.90 ng/ml/h, P=0.0031; ALD basal: 111.5 --> 73.0 pg/ml, P=0.0258; ALD stimulated: 392.5 --> 236.0 pg/ml, P=0.0157. The postoperative decrease in the PRA correlated with the changes in PTH levels (r=0.5442, P < 0.05, n=16) but did not correlate with the changes in serum calcium concentrations. Both the fasting and stimulated insulin levels decreased after surgery but remained within the normal range: insulin fasting: 10.2 --> 5.0 mIU/l, P=0.0218; insulin area under the curve: 5555 --> 3296 mIU/l*min, P=0.0218. There was no correlation between the changes in insulin levels and PTH or ion levels. Sodium, potassium and blood glucose levels remained unaffected by parathyroid surgery. CONCLUSIONS: In a population of normotensive hyperparathyroid patients an increased activity of the renin-aldosterone system related to PTH was found and surgery resulted in a small and insignificant decrease in blood pressure. This change was accompanied by a significant decrease in the activity of the renin-aldosterone system indicating the role of the renin-aldosterone system in the regulation of blood pressure in PHPT. Both fasting and stimulated insulin values decreased following removal of the parathyroid tumor, but with no individual correlation with PTH and calcium levels.

Two once-a-month injectable contraceptive formulations, HRP112 (depot-medroxyprogesterone acetate, 25mg and estradiol cypionate, 5mg.) and HRP102 (norethisterone enantate, 50 mg and estradiol valerate, 5 mg,) were compared in two groups of women witn regard to effectiveness, reported complaints and reasons for discontinuation. A total of 2328 women were recruited into a seventeen-centre, randomized clinical trial. Follow-up was for a period of one year and resulted in a total of 10,969 women-months of experience of HRP112 and 10,608 women-months of experience with HRP102.

Uncoupling protein (UCP) is expressed only in brown adipocytes and is responsible for the unique thermogenic properties of this cell type. The novel brown preadipocyte cell line, HIB-1B, expresses UCP in a strictly differentiation-dependent manner. Transgenic mice studies have shown that a region from kb -2.8 to -1.0 of the marine UCP gene is required for brown adipocyte-specific expression. Subsequent analysis identified a potent 220-bp enhancer from kb -2.5 to -2.3. We show that this enhancer is active only in differentiated HIB-1B adipocytes, and we identify a peroxisome proliferator-activated receptor gamma (PPARgamma) response element, referred to as UCP regulatory element 1 (URE1), within the enhancer. URE1 has differentiation-dependent enhancing activity in HIB-1B cells and is required for enhancer action, since mutations of URE1 that block protein binding abolish enhancer activity. We also show that PPAR gamma antibodies block binding to URE1 of nuclear extracts from cultured brown adipocytes and from the brown adipose tissue of cold-exposed mice. Protein binding to URE1 increases substantially during differentiation of HIB-1B preadipocytes, and PPAR-gamma mRNA levels increase correspondingly. Although forced expression of PPAR gamma and retinoid X receptor alpha activates the enhancer in HIB-1B preadipocytes, these receptors are not capable of activating the enhancer in NIH 3T3 fibroblasts. Our results show that PPAR gamma is a regulator of the differentiation-dependent expression of UCP and suggest that there are additional factors in HIB-1B cells required for brown adipocyte-specific UCP expression.

OBJECTIVE
To investigate the effect of varying amounts of iodine intake on the prevalence of thyroid dysfunction, autoimmunity and goitre in old age. DESIGN
The first screening study where elderly subjects with varying amounts of iodine supply but from the same geographical and ethnographical region (Carpathian basin) were compared, and all hormone measurements and ultrasonography were performed by the same laboratory or person. PATIENTS
Nursing home residents were screened for thyroid disorders from: (A) an iodine-deficient area, Northern Hungary (n = 119; median age 81 years; median iodine excretion (MIE) 0.065 mumol/mmol creatinine (equivalent to 72 mug/g creatinine); (B) an area of obligatory iodinated salt prophylaxis since the 1950s, Slovakia (n = 135; median age 81 years, MIE 0.090 mumol/mmol creatinine (equivalent to 100 mug/g creatinine)) and (C) an abundant iodine intake area, Eastern Hungary (n = 92; median age 78 years; MIE 0.462 mumol/mmol creatinine (equivalent to 513 mug/g creatinine)). MEASUREMENTS
TSH, T4, free T4, T3, thyroglobulin (Tg), antibodies to Tg (AbTg) and to thyroid peroxidase (AbTPO), iodine excretion, ultrasonography of the thyroid gland. RESULTS
In regions A, B and C, the prevalence of unsuspected clinical hypothyroidism was 0.8%, 1.5% and 7.6% (P = 0.006), with all cases except one being antibody positive (Ab+). The occurrence of subclinical hypothyroidism was 4.2% in region A, 10.4% in region B and 23.9% in region C (P &lt; 0.001), but only 3 of 22 cases with subclinical hypothyroidism from region C were Ab+. The overall prevalence of Ab positivity (either antiTg+ or antiTPO+) was similar in the three regions (A, 19.3%; B, 24.4%; C, 22.8%). The occurrence of hyperthyroidism (clinical plus subclinical) was 3.4% in region A, 3.0% in region B and 0% in region C (not significant). The rate of elevated Tg levels was similar in the three regions. The prevalence of goitre was 39.4%, 16.4% and 12.2% (P &lt; 0.001), respectively in regions A, B and C. In euthyroid subjects the mean ultrasonographically determined thyroid volume was 21.9 ml in region A, 13.6 ml in region B and 15.1 ml in region C (ANOVA F = 5.76; P = 0.0038). There was no significant difference in the occurrence of cases with hypoechogenic echotexture of the thyroid gland. CONCLUSIONS
The screening for hypothyroidism in nursing home residents living in iodine-rich regions is justified by the high prevalence of unsuspected clinical hypothyroidism. The high prevalence of antibody positivity in old age is independent of the iodine supply, but iodine supply has a determining role in the development of autoimmune hypothyroidism in the aged. Most cases of subclinical hypothyroidism in iodine-rich regions are not of autoimmune origin. In old age, hypoechogenic texture of the thyroid gland is not predictive of thyroid dysfunction.

Abstract: This report describes the disarming of Agrobacterium tumefaciens Chry5, a strain highly tumorigenic on soybean. Disarming was achieved by removing an approximately 16.5-kb segment of the 285-kb Ti plasmid pTiChry5, including approximately 4 kb of the oncogenic T-DNA and an extended region right of the T-DNA, and replacing it with a gene for carbenicillin resistance, through homologous recombination. The deletion was confirmed with Southern analysis, and the loss of tumorigenicity was verified in tobacco and tomato plant stem inoculation assays. The deletion mutant, named KYRT1, successfully transferred the β-glucuronidase (GUS) gene into tobacco leaf tissue, producing GUS-expressing callus which could be regenerated into viable plants. In a comparative study, the transformation efficiency of A. tumefaciens KYRT1, GV3850, and EHA105 was assayed by inoculating cotyledonary node explants. The results of this study revealed that, in a binary vector system, KYRT1 is equally or more effective than EHA105 or GV3850 at delivering DNA into soybean.

1. Mutations in the gene encoding the alpha 1‐subunit of the skeletal muscle dihydropyridine (DHP) receptor are responsible for familial hypokalaemic periodic paralysis (HypoPP), an autosomal dominant muscle disease. We investigated myotubes cultured from muscle of patients with arginine‐to‐histidine substitutions in putative voltage sensors, IIS4 (R528H) and IVS4 (R1239H), of the DHP receptor alpha 1‐subunit. 2. Analysis of the messenger ribonucleic acid (mRNA) in the myotubes from such patients indicated transcription from both the normal and mutant genes. 3. In control myotubes, the existence of the slow L‐type current and of two rapidly activating and inactivating calcium current components (T‐type with a maximum at about ‐20 mV and ‘third type’ with a maximum at +10 to +20 mV) was confirmed. In the myotubes from patients with either mutation, the third‐type current component was seen more frequently and, on average, with larger amplitude. 4. In myotubes with the IVS4 mutation (R1239H) the maximum L‐type current density was smaller than control (‐0.53 +/‐ 0.31 vs. ‐1.41 +/‐ 0.71 pA pF‐1). The voltage dependence of activation was normal, and hyperpolarizing prepulses to ‐120 mV for 20 s did not increase the reduced current amplitude during test pulses. 5. In myotubes with the IIS4 mutation (R528H) the L‐type current‐voltage relation, determined at a holding potential of ‐90 mV, was normal. However, the voltage dependence of inactivation was shifted by about 40 mV to more negative potentials (voltage at half‐maximum inactivation, V1/2 = ‐41.5 +/‐ 8.2 vs. ‐4.9 +/‐ 4.3 mV in normal controls).(ABSTRACT TRUNCATED AT 250 WORDS)