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Proteus mirabilis PM23, unlike other motile strains of the species, differentiates in rich fluid media to form nonseptate filaments resembling the swarmer cells formed on solid media. The swarming activity of PM23 is greater than that of the other strains on solid media and it grows faster than another strain, IM47, in differentiation-supporting broth. This faster growth is not exhibited in broth that does not support differentiation. The differentiation of PM23 in brain-heart infusion broth occurs over a wide range of pH and temperature. Inhibitors of swarming on agar plates (p-nitrophenylglycerol and boric acid) and three chelating agents (EDTA, sodium cyanide, and sodium diethyldithiocarbamate) stop differentiation both on plates and in brain-heart infusion broth; however, EGTA is not effective even at 10 mM (10 times the minimum inhibitory concentration of EDTA). The inhibitory mechanisms of p-nitrophenylglycerol and boric acid are different from that of the chelating agents. The timing of EDTA inhibition suggests generation of a "signal" to differentiate after about 2 h growth. Prevention of differentiation by addition of Fe2+ and Zn2+ up to near the time that differentiation should appear suggests that these cations have a crucial involvement in the process of initiation. However, they are not effective as additives in allowing differentiation to occur in defined media or even nutrient broth; the further addition of nucleotides or cAMP was equally ineffective.

1. The relationship of reciprocal change on the electrocardiogram, at the time of acute myocardial infarction, to exercise-induced ST segment depression and coronary anatomy was studied in 125 post-infarct patients. 2. Eighty-three patients had reciprocal changes, 90 had exercise-induced ST depression and 72 had both of these findings. 3. Patients with reciprocal changes had larger myocardial infarctions, as assessed by peak enzyme release and ejection fraction, than patients without this finding. 4. Multi-vessel disease was significantly more common among patients with reciprocal changes and those with exercise-induced ST depression compared with patients without these findings. 5. The exercise test was more sensitive and had a higher predictive accuracy than reciprocal change when electrocardiographic changes were compared with findings at coronary angiography. 6. With both tests the antero-lateral leads were significantly more sensitive, but less specific, than the inferior leads in classifying patients. 7. Thus while both tests yielded information with regard to coronary anatomy in post-infarct patients, the exercise test was a better predictor of coronary anatomy than reciprocal change. 8. Therefore, reliance should not be placed on the presence or absence of reciprocal change alone when assessing patients for further investigation after myocardial infarction.

A defined medium for Aquaspirillum serpens VHL allows the replacement of the complex media now in use. It was developed by batch culture methods but supports growth in continuous culture. A basal salts medium supplemented with L-aspartic acid, L-alanine, and L-glutamic acid provided the best growth (turbidity), as long as ammonium chloride was omitted. Ammonium chloride caused either a lag or a reduction or a complete inhibition of the growth of A. serpens VHL on the above amino acids and other organic supplements depending on the combination used. Ammonium sulfate and ammonium hydroxide with L-glutamic acid allowed growth, but the lag period was increased in shake flask cultures. Vitamins, cysteine hydrochloride, and carbon dioxide had no effect on the growth rate. Viability (less than 50%) was inadequate to maintain continuous culture with L-glutamic acid as the sole source of carbon and nitrogen. Combinations of amino and carboxylic acids were then tested and, of these, L-glutamic acid (1 g/liter) and L-histidine (75 mg/liter) without ammonium chloride in the basal salts medium supported growth in batch and continuous culture. L-Glutamic acid was the limiting substrate for growth.

The study of sections, freeze-cleaved, and whole-cell preparations of Deinococcus radiodurans supported the contention that septa close assymmetrically and originate from discrete opposing locations on the cell surface. Tetrads and the larger associations (sheets) of cells in some strains were formed by alternate and synchronized divisions in two planes. The polarity initiating the second division in cells of the Sark strain, in particular, was often expressed in slower growing cells before completion of the first division so that the advancing margins of the first septum were diverted towards the nearest new pole; the resulting gap was closed later on, and consequently, the cell compartments of this coccus were in communication for some time after two rounds of nuclear segregation. Freeze cleaving showed that the initial generation of septa involved a short sulcus in the plasma membrane and not a circumferential infolding. The shape and form of the developing septum was inferred from sections but was displayed in whole-cell preparations by a technique which selectively and positively stained a septal component. Positive staining of the septum with uranyl salts was appreciable when the relative stainability of the peripheral wall (mainly peptidoglycan) was reduced by pretreatment with salts of low atomic weight metals (0.01-1.0%, w/v) such as cobalt, copper, iron, or zinc. Examination of these whole-cell preparations by stereoscopy showed that the septal diaphragm closes as a slit or long oval, and the advancing margin shows curvature towards the next axis of division. The mechanism and exact site of this positive staining was not elucidated; vancomycin blocking of the uncross-linked peptides of peptidoglycan was almost as effective as the transition metal salts as a foretreatment for staining septa.

Electron microscopy of the Azotobacter vinelandii tetragonal surface array, negatively stained with ammonium molybdate in the presence of 1 mM calcium chloride, showed an apparent repeat frequency of 12 to 13 nm. Image processing showed dominant tetrad units alternating with low-contrast cruciform structures formed at the junction of slender linkers extending from corner macromolecules of four adjoining dominant units. The actual unit cell showed p4 symmetry, and a = b = 18.4 nm. Distilled water extraction of the surface array released a multimeric form of the single 60,000 molecular-weight protein (S protein) which constitutes the surface layer. The molecular weight of the multimer was estimated at 255,000 by gel filtration, indicating a tetrameric structure of four identical subunits and suggesting that this multimer was the morphological subunit of the S layer. Tetrameric S protein exhibited low intrinsic stability once released from the outer membrane, dissociating into monomers when incubated in a variety of buffers including those which served as the base for defined media used to cultivate A. vinelandii. The tetramer could not be stabilized in these buffers at any temperature between 4 and 30 degrees C, but the addition of 2 to 5 mM Ca2+ or Mg2+ completely prevented its dissociation into monomers. Circular dichroism measurements indicated that the secondary structure of the tetramer was dominated by aperiodic and beta-sheet conformations, and the addition of Ca2+ did not produce any gross changes in this structure. Only the tetrameric form of S protein was able to reassemble in vitro in the presence of divalent cations onto the surface of cells stripped of their native S layer.

Septa can be demonstrated in sections of Escherichia coli strains B and B/r after fixation with acrolein and glutaraldehyde. The septum consists of an ingrowth of the cytoplasmic membrane and the mucopeptide layer; the outer membrane is excluded from the septum until the cells begin to separate. Mesosomes have also been observed. The septum is highly labile and, except in the chain-forming strains, E. coli D22 env A and CRT 97, not easily preserved by standard procedures. The labile nature of the septum may be due to the presence of autolysin(s) located at the presumptive division site. Blocking division by addition of ampicillin (2 to 5 mug/ml) to cells of E. coli B/r produces a bulge at the middle of the cells; bulge formation is stopped by addition of chloramphenicol. Cephalosporins also induce bulge formation but may stop cell elongation as well as division. Bulge formation, due to the presumed action of an autolysin(s), may be an initial step in the septation sequence when the mucopeptide is modified to allow construction of the septum. In a nonseptate filament-forming strain, PAT 84, which ceases to divide at 42 C, bulge formation only occurs in the presence of ampicillin at the time of a shift-down at 30 C or at 42 C in the presence of NaCl (0.25 to 0.34 M). Experiments with chloramphenicol suggest that the filaments are fully compartmentalized but fail to divide owing to the inactivation, rather than loss of synthesis, of an autolysin at 42 C.

The monocytosis-producing activity (MPA) from Listeria monocytogenes is shown to be associated with the cell envelope. Both MPA and immunosuppressive activity were readily extracted with aqueous solvents and separated as two independent activities by gel filtration and ion-exchange chromatography. As little as 10 microng of the resulting MPA-containing fraction caused a ninefold elevation in the level of circulating monocytes. The molecular weight of the fraction was approximately 22,000, and it contained phosphorus and carbohydrate.

A 43-year-old woman with a 12-year history of palpitation was found to have recurrent monomorphic ventricular tachycardia resistant to beta-blockade but abolished by sleep.

Electron microscopy of the cell envelope of Spirillum putridiconchylium, using negatively stained, thin-sectioned, and replicated freeze-etched preparations, showed two superficial wall layers forming a complex macromolecular pattern on the external surface. The outer structured layer was a linear array of particles overlying an inner tetragonal array of larger subunits. They were associated in a very regular fashion, and the complex was bonded to the outer, pitted surface of the lipopolysaccharide tripartite layer of the cell wall. The relationship of the components of the two structured layers was resolved with the aid of optical diffraction, combined with image filtering and reconstruction and linear and rotary integration techniques. The outer structural layer consisted of spherical 1.5-nm units set in double lines determined by the size and arrangement of 6- by 3-nm inner structural layer subunits, which bore one outer structural layer unit on each outer corner. The total effect of this arrangement was a double-ridged linear structure that was evident in surface replicas and negatively stained fragments of the whole wall. The packing of these units was not square but skewed by 2 degrees off the perpendicular so that the "unit array" described by optical diffraction and linear integration appeared to be a deformed tetragon. The verity of the model was checked by using a photographically reduced image to produce an optical diffraction pattern for comparison with that of the actual layers. The correspondence was nearly perfect.

The visual interpretation of Thallium-201 myocardial images is made more difficult by nonhomogeneity of myocardial tracer uptake in normal studies. To increase the objectivity of the study, the variation in count density in different myocardial areas has been calculated using a computer regions of interest technique in 14 healthy, young subjects following intravenous injection of the radionuclide at rest and in 10 after injection during maximal exercise. The "normal ranges" for regional Thallium-201 uptake so obtained are presented and discussed.

In a district general hospital's coronary care unit (CCU) 197 patients with chest pain were admitted over a 6-month period and in 131 an acute myocardial infarction (AMI) was confirmed. 67 (51%) were eligible for thrombolytic therapy, on criteria laid down for a trial of streptokinase. Criteria for thrombolysis were not fulfilled in 41 (31%) and 12 patients (9%) had contraindications. These results suggest that around half of all patients with AMI and about one-third of patients presenting with chest pain and admitted to a CCU would be suitable for thrombolytic therapy. These data do not support the view that such therapy may be applicable to only a small minority of patients with AMI.

?The cardiovascular effects of the cardioselective beta, agonist prenalterol have been studied in nine patients with severe chronic congestive cardiac failure and in six patients with left ventricular dysfunction resulting from previous myocardial infarction. In the patients with cardiac failure intravenous prenalterol in a dosage of 1.5 microgram/kg bodyweight increased the cardiac index from 1.8 +/- 0.1 to 21.+/- 0.1 1/min per m2 and the left ventricular ejection fraction from 22 +/- 3 to 28 +/- 3%. There was a modest but significant increase in heart rate from 76 +/- 3 to 87 +/- 4 beats/min. Systemic vascular resistance fell from 2285 +/- 51 to 2041 +/- 534 dynes s-1 cm-5. On exercise, the left ventricular filling pressure fell from 33 +/- 6 to 26 +/- 3 and both cardiac index and stroke index increased by 13% and 16%, respectively. There was no significant change in heart rate or systemic blood pressure. In the patients with left ventricular dysfunction, coronary sinus blood flow increased from 107 +/- 11 to 133 +/- 12 ml/min but the increase in myocardial oxygen consumption was small and not significant (11.6 +/- 1.2 and 14.5 +/- 1.9 ml/min). In all patients there was no evidence that prenalterol was arrhythmogenic.

The salt-tolerant bacterium Halomonas elongata makes a variety of physiological adaptations in response to increases in the salt concentration of its growth medium. The cell walls become more compact and internally coherent. The overall lipid pattern shows an increased amount of negatively charged lipids. In addition, the peptidoglycan composition of H. elongata, although not changing in response to increased NaCl, contains the hydrophobic amino acid leucine which is unique among bacterial species. The results suggest that H. elongata is able to live in a wide variety of salt concentrations because it alters its cell physiology in ways which increase both structural integrity and the amount of less-mobile, "structured" cell water, making the cells less susceptible to NaCl-induced dehydration.

Electron micrographs of disintegrating units of the outer, structured (HP) layer of Spirillum serpens and of the isolated protein obtained from the HP layer revealed V- and Y-shaped and linear profiles. Interpretation of these forms, influenced by the seemingly trimeric form of the isolated protein and by biochemical data, suggested that the protein subunits were identical and Y shaped. A model is proposed for the assembly of the Y-shaped subunits to form a hexagon composed of two triads (three Y-shaped subunits each). The isolated protein adsorbed to a template of wall fragments (basal layer) to the same degree (over 90%) in high concentrations of Na+, K+ (5 X 10(-2) M), Ca2+, Sr2+, and Mg2+ (10(-2) M). At a lower concentration (4 x 10(-5) M) of the cations there was differential adsorption of the protein. Adsorption to the template in the presence of each cation, followed by dilution, also led to differential release of the protein. The adsorption of the protein to the basal layer was correlated with reassembly of the HP layer on the template. The mechanisms seem to be: (i) an ionic strength-dependent reassembly, which results in an HP layer loosely attached to the template (this layer is easily dissociated by decreasing the ionic strength); and (ii) a cation-specific (Ca2+ or Sr2+, but not Mg2+, Na+, or K+) mechanism independent of ionic strength. In this latter case, the specific cations presumably form strong noncovalent "salt" linkages between triads and the basal layer, enabling stable hexagons and the HP layer to be formed.

In a prospective study, 20 patients with acute myocardial infarction were randomly assigned in a double-blind fashion to treatment with intravenous metoprolol followed by oral metoprolol or placebo. All patients underwent hemodynamic monitoring for 24 hours. Plasma adrenaline and noradrenalin levels were estimated at baseline (mean 6.0 +/- 0.9 hours from onset of symptoms) and at 1 and 24 hours after the start of therapy. Plasma adrenaline and noradrenalin levels were elevated in all but one patient, with a further increase at 1 hour after administration of metoprolol (p less than 0.05). At baseline pulmonary capillary wedge pressure was directly related to both plasma adrenaline (r = -0.44; p less than 0.05) and noradrenalin levels (r = -0.44; p less than 0.05). There was also an inverse relationship between stroke volume index and the plasma noradrenalin level (r = -0.44; p less than 0.05) but not the plasma adrenaline level. These relationships were lost after the baseline measurements. However, between baseline and 1 hour there was a close relationship between the change in systemic vascular resistance and the changes in both adrenaline (r = -0.48; p less than 0.05) and noradrenalin levels (r = -0.66; p less than 0.01). Thus, in the early stages of myocardial infarction high plasma catecholamine levels are associated with the hemodynamic markers of severe left ventricular damage. Beta-adrenergic blockade with metoprolol produced a further increase in catecholamine levels that was associated with an increase in systemic vascular resistance.

1. Fourteen patients with angina with obstructive coronary artery disease were treated with propranolol, given four times daily, or penbutolol given once daily. 2. The frequency of anginal episodes and glyceryl trinitrate consumption were monitored using diary cards. Heart rate and blood pressure were recorded at rest and on exercise. Left ventricular function was assessed using systolic time intervals. 3. Penbutolol given once daily showed similar effects as propranolol, using both clinical assessment and changes in physiological parameters.

The Triton X-100-insoluble wall fraction of Aquaspirillum serpens VHA contained three major proteins: the regularly structured (RS) superficial protein (molecular weight 140,000) and two peptidoglycan-associated proteins (molecular weights, 32,000 and 33,000). The molecular arrangement and interactions of the outer membrane and RS proteins were examined with the use of bifunctional cross-linking reagents. The peptidoglycan-associated and RS proteins were not readily cross-linked in either homo- or heteropolymers. This suggests that the free amino groups are not suitably disposed for cross-linking. Some high-molecular-weight multimers of the RS protein were produced, but the subunit structure of the RS array was not stabilized by cross-linking. The peptidoglycan-associated proteins were cross-linked to high-molecular-weight multimers, but no dimers or trimers were produced. This result suggests that these proteins exist in the outer membrane as multimers larger than trimers.

Isolated walls of Spirillum serpens VHA contained lipid, lipopolysaccharide, and protein in amounts similar to those of other gram-negative organisms. The loosely bound lipids consisted mainly of phosphatidylethanolamine, lyso-phosphatidylethanolamine, phosphatidylglycerol, and diphosphatidylglycerol. Lipopolysaccharide was tightly bound to the wall and could only be removed in a substantial amount after digestion of the wall with Pronase. The lipopolysaccharide contained L-glycero-D-mannoheptose, rhamnose, glucosamine, ethanolamine, and phosphate in common with many of the lipopolysaccharides isolated from the Enterobacteriaceae. However, 2-keto-3-deoxyoctonic acid was not detected. Several unidentified sugars were present. The fatty acid composition resembled that found in lipopolysaccharides isolated from various pseudomonads. Two major regions were identified in the polysaccharide moiety, one apparently corresponding to the core polysaccharide and the other corresponding to the side-chain polysaccharide as in enterobacterial and pseudomonad lipopolysaccharides. The side chains were obtained as low-molecular-weight material and their structure was partially elucidated by the isolation and partial characterization of N-acetylglucosaminyl-(1 leads to 4)-rhamnose.

A 65-year-old man with unstable angina had a critical left anterior descending coronary artery stenosis which progressed to total occlusion, without evidence of acute myocardial infarction. Thallium imaging revealed defects in the distribution of the left anterior descending coronary artery on exercise and redistribution, 4 h later. 99mTc radionuclide angiography showed a fall in left ventricular ejection fraction on exercise, and contrast cineangiography showed an extensive area of akinesia. Percutaneous transluminal coronary angioplasty was successful without any complications. Repeat radionuclide studies demonstrated improvement of both myocardial perfusion and function. Angiography at 1 year showed normal left ventricular contraction and no evidence of recurrent stenosis. The patient is free of angina, on no medication 2 years after angioplasty. This case illustrates the feasibility of myocardial salvage by elective coronary angioplasty in patients with unstable angina total coronary occlusion.

The clinical effects of the oral beta 1 partial agonist, prenalterol, were investigated in 37 patients (29 male, eight female; mean age 57 years) with chronic ischaemic left ventricular failure using a placebo controlled randomised double blind protocol over six months. All patients were limited by dyspnoea (New York Heart Association class III) despite treatment with digoxin and diuretics. Twenty eight patients completed the protocol. Moderate clinical improvement was seen in the prenalterol group, whereas there was little change in the placebo group. Bicycle exercise capacity increased over six months in the prenalterol and placebo groups but only achieved statistical significance for prenalterol when compared with baseline values. Maximum exercise heart rate was significantly reduced in the prenalterol group compared with placebo. Radionuclide left ventricular ejection fraction at rest and during exercise and cardiothoracic ratio showed no significant improvement in either group over six months. Prenalterol was well tolerated and produced no increase in frequency of angina or ventricular arrhythmias. Prenalterol produced clinical benefits and improved exercise tolerance while reducing exercise heart rate. A moderate placebo response was noted. The apparent beta blocking effect of prenalterol may be as important as the beta 1 agonist effect in producing these benefits. Prenalterol has, however, been withdrawn because of side effects in animals.

The cell surface of Aquaspirillum bengal was devoid of superficial wall structure. When cells were freeze-cleaved and etched, multiple fracture planes through the cell envelope were exposed, which was unusual for an aquaspirillum. These included both convex and concave surfaces and they are compared with those of other gram-negative bacteria.

The methods used for the isolation of regularly structured (RS) surface array proteins of a range of prokaryotes are described. Most RS proteins can be selectively solubilized from envelope preparations with low concentrations of urea or guanidine hydrochloride. Sodium dodecyl sulfate - polyacrylamide gel electrophoresis analysis of the protein extracts shows that most RS arrays are composed of a single polypeptide that may contain carbohydrate. The molecular weight of the proteins varies from 41 000 to 200 000. Possible reasons for the presence of more than one polypeptide in RS protein preparations are discussed, as well as the evidence for proteolytic degradation of some RS proteins during isolation. Structural features of the RS proteins are described and the importance of protein conformation to assembly of the arrays is indicated.

Isolated walls of Bacillus subtilis Marburg, prepared in a manner which avoided metal contamination other than by the growth medium, were incubated in dilute metal solutions, separated by membrane filtration (0.22 mum), and monitored by atomic absorption to give uptake data for 18 metals. Substantial amounts of Mg2+, Fe3+, Cu2+, Na+, and K+ (amounts which were often visible as Au3+, and Ni2+ (the higher atomic-numbered elements also visible as electron scattering), and small amounts of Hg2+, Sr2+, Pb2+, and Ag+ were taken into the wall. Some (Li+, Ba2+, Co2+, and Al3+) were not absorbed. Most metals which had atomic numbers greater than 11 and which could be detected by electron microscopy appeared to diffusely stain thin sections of the wall. Magnesium, on the other hand, partitioned into the central region, and these sections of walls resisted ruthenium red staining, which was not true for the other metals. Areas of the walls also acted as nucleation sites for the growth of microscopic elemental gold crystals when incubated in solutions of auric chloride. Retention or displacement of the metals was estimated by a "chromatographic" method using the walls cross-linked by the carbodiimide reaction to adipic hydrazide agarose beads (which did not take up metal but reduced the metal binding capacity of the walls by ca. 1%) packed in a column. When a series of 12 metal solutions was passed through the column, it became evident that Mg2+, Ca2+, Fe3+, and Ni2+ were strongly bound to the walls and could be detected by both atomic absorption and by their electron-scattering power in thin sections, qhereas the other metals were fisplaced or replaced. Partial lysozyme digestion of the walls (causing a 28% loss of a [3H]diaminopimelic acid label) greatly diminished the Mg2+ retention but not that of Ca2+, Fe3+, or Ni2+, indicating that there are select sites for various cations.

When Caryophanon latum was exposed to egg white lysozyme in isotonic sucrose and observed by phase-contrast microscopy, protoplasts emerged along the length of the trichomes, apparently at sites corresponding to cross septa. Electron microscopy of sections revealed that this enzyme initially attacked the core of the septal peptidoglycan and delamination of septa resulted. The inner densely staining layer of the lateral and polar wall (considered to contain peptidoglycan as the major component) remained intact except for destruction at the advancing tip of partial septa; protoplasts or cell debris could escape from the gaps formed at developing septa. Treatment of intact trichomes with pronase, a lipase - phospholipase C mixture, EDTA, glutaraldehyde, or heat, before exposure to egg white lysozyme did not alter this pattern nor did it render the remaining peptidoglycan more susceptible to attack. The wall material external to the peptidoglycan was solubilized by pronase. The peptidoglycan remaining after lysozyme treatment was not morphologically changed by treatment with pronase. Lysozyme derived from Chalaropsis hydrolyzed incomplete septa initially, while the lateral and polar wall and complete septa were degraded later. Therefore, it is most probable that the inner dense layer does contain the peptidoglycan component and that some biochemical maturation distinguishes the substrate for these enzymes in the lateral wall and septa.

Specific regions of the cell envelope associated with the flagellar basal complex of the gram-negative bacterium Aquaspirillum (Spirillum) serpens were identified by studying each of the envelope layers: outer membrane, mucopeptide, and plasma membrane. The outer membrane around the flagella insertion site was differentiated by concentric membrane rings and central perforations surrounded by a closely set collar. The perforations in both the outer membrane and the isolated mucopeptide layer were of a size accomodating the central rod of the basal complex but smaller than either the L or the P disks. The P disk of the complex may lie between the mucopeptide and the outer membrane. Electron microscopy of intact, spheroplasted, or autolyzed preparations did not adequately resolve the location of the inner pair of disks of the basal complex. Freeze-etching, however, revealed differentiation within the plasma membrane that appeared to be related to the basal complex. The convex fracture face showed depressions which are interpreted as impressions of a disk surrounded by a set of evenly spaced macromolecular studs and containing a central "plug" interpreted as the central rod. In thin sections, blebs, which appear to be associated with the flagellar apparatus, were seen on the cytoplasmic side of the plasma membrane. Superimposing the dimensions of the flagellar basal complex and the spacings of the cell envelope layers and using the position of the L disk within the outer membrane for reference, showed that the S disk might be within and the M disk beneath the plasma membrane. A tentative model was developed for comparison with that based on the structure of the Escherichia coli basal complex.

Fifteen patients with moderately severe and severe chronic congestive heart failure were studied to determine the central haemodynamic results of short term increases in lower body positive pressure. Central haemodynamic variables were determined by Swan-Ganz thermodilution catheterisation and arterial cannulation. Graded increases in lower body positive pressure were applied to supine patients using Medical Anti-Shock Trousers (MAST). Increasing lower body positive pressure by 25 mm Hg and 55 mm Hg caused increases in mean right atrial pressure (6.0 to 13.2 to 17.9 mm Hg; p less than 0.001 and p less than 0.0001 respectively) and mean pulmonary artery pressure (26.8 to 35.5 to 41.3 mm Hg; p less than 0.05 and p less than 0.01 respectively). No significant changes were seen in left heart filling pressures or in pulmonary vascular resistance. Furthermore, there were no significant increases in indices of cardiac work (cardiac index, left ventricular stroke work index, right ventricular stroke work index or cardiac power output) despite the increased right heart filling pressures. These results show that in patients with longstanding severe congestive heart failure, short term increases in cardiac return may increase right heart pressures but do not appear to cause either beneficial or detrimental changes in left heart haemodynamic indices.

Through use of an initial fixative employing a combination of crotonaldehyde and glutaraldehyde, septa were preserved in thin sections of dividing cells of strains of Pseudomonas aeruginosa, Salmonella typhimurium, Shigella sonnei, and Escherichia coli when grown at 30 C in a dilute basal medium. The same procedures, however, revealed only a constrictive division process in Proteus vulgaris and Erwinia sp. This adds to the evidence that septation, although difficult to demonstrate, is the process of cell division in the enteric gram-negative rods and the pseudomonads and that constriction is a fixation artifact in these organisms.

Polar membrane in Campylobacter jejuni has been visualized on membrane vesicles. It was composed of doughnut-shaped particles 5-6 nm in diameter, with stalks, arranged in a hexagonal array. This structure was stabilized on the membrane by a high ionic strength buffer in the presence of 2-mercaptoethanol. Histochemical staining indicated localized ATPase activity at the poles of the cells. An ATPase with distinctive properties has been isolated and purified from this organism; it gives a specific activity of approximately 0.3 units/mg of protein. Electron microscopy showed doughnut-shaped particles 5-6 nm in diameter. Nondissociating and sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified enzyme revealed, respectively, a single band with ATPase activity and a molecular weight of ca. 75,000 Da. The enzyme was cold labile and activity was abolished by trypsin. Dicyclohexylcarbodiimide inhibited the membrane-bound form of the enzyme, but did not inhibit the soluble form. Oligomycin had no inhibitory activity on either form of the enzyme. The enzyme specifically hydrolysed ATP, but other nucleotide substrates were not degraded. The enzyme was activated by Mg2+ and inhibited by Ca2+, whereas other ions had no effect on activity. Antibodies prepared to this enzyme bound to the polar regions of whole cells as shown by protein A - colloidal gold immunoelectron microscopy. The antibodies to this ATPase cross reacted (shown by Western blotting) with four proteins from a whole-cell extract of this organism, two proteins in Aquaspirillum serpens MW5, and three proteins from Escherichia coli K12. They did not cross-react with any proteins from Spirillum volutans, Methanococcus voltae, Vibrio cholerae, or rat liver mitochondria. Antibodies raised against the F1-ATPase of E. coli K12 cross reacted with six proteins in a whole-cell extract of this organism, and one protein species in each of the whole-cell extracts of V. cholera, A. serpens MW5, S. volutans, and rat liver mitochondria. These antibodies did not recognize any whole cell proteins from either C. jejuni or M. voltae. These results along with the ATPase activity localized by histochemical staining suggest that polar membrane is an assembly of ATPase molecules at the poles of the cell and that the ATPase isolated from C. jejuni is serologically and structurally unusual.

1. The renal extraction of insulin and thyroid hormones T3 and T4 was studied in man by right renal vein catheterization. 2. The mean renal extraction of insulin was 0-46, suggesting that the right renal vein should be utilized in comparable studies. 3. No renal extraction of thyroid hormones was detected.

Chromosomal DNAs of selected Bacteroides organisms whose relatedness had been previously determined by "conventional" filter-annealing studies (J. L. Johnson, Int. J. Syst. Bacteriol. 28:245, 1978) were further analyzed by restriction endonuclease analysis coupled with the Southern hybridization procedure (E. M. Southern, J. Mol. Biol. 98:503, 1975). By comparing their EcoRI restriction fragment patterns in agarose gel electrophoresis, each Bacteroides strain could be clearly differentiated. As a simple and direct means for comparison purposes this method was particularly useful for differentiating genetically similar organisms such as Bacteroides strains of the same species which shared greater than 75% homology. In contrast, bacterial chromosomal restriction endonuclease analysis in conjunction with Southern hybridizations was most effectively used to determine the significance of low levels of homology (less than 24%) as this technique provided additional information on the nature and relative distribution of that homology when the areas of homology were displayed as reproducible bands in autoradiograms.

Rest Thallium-201 myocardial images were abnormal in 20 out of 40 patients with arteriographically proven coronary artery disease. The myocardial image appearances did not accurately reflect the extent of coronary artery disease present. However, in 35 of the 40 patients (88%) the presence or absence of abnormalities on the rest myocardial image correleted respectively with the presence or absence of abnormal wall motion at left ventriculography. Most rest image abnormalities could be attributed to previous myocardial infarction, but in six patients myocardial ischaemia was possibly the cause. These results suggest that though myocardial fibrosis is usually the cause of rest myocardial image abnormalities in coronary artery disease, this is not invariably so. The possible therapeutic implications are discussed.

A comparison was made of the effects of cis-tetrachlorodiaminoplatinum (IV) (cis-TCDPt), rans-TCDPt), and hexachloroplatinum (HCP) on growth and cell division of Escherichia coli strains D21 and D22. At or below 40 microgram/mL, cis-TCDPt inhibited cell division but not growth, DNA, or protein synthesis, although areas of increased electron density could be demonstrated in treated cells. In contrast, 40 microgram/mL of trans-TCDPt or HCP inhibited growth. Trans-TCDPt-treated cells developed condensed nucleoids; HCP-treated cells showed no obvious cytological changes to correlate with growth inhibition. Combination of cis-TCDPt with nalidixic acid, both at one-half the lowest filament-forming concentrations, resulted in formation of filaments, suggesting an additive effect. Combination of cis-TCDPt followed by ampicillin on E. coli B/r resulted in single bulges near the center of the filaments. Cis-TCDPt could therefore inhibit an initial step in the septation sequence, possibly at the level of the regulation of the hydrolytic enzymes. Whether cis-TCDPt exerts its effect by interreaction with DNA or with a membrane target is still uncertain.

Three methods of analyzing stress thallium-201 myocardial images were performed on 79 patients with suspected coronary artery disease. The results of visual analysis of unprocessed Polaroid images, background subtracted and contrast enhanced computer generated color television images, and a semiquantitative regions-of-interest method were each compared to the coronary arteriographic findings in all patients. Analysis by the semiquantitative method achieved the highest accuracy for the classification of patients as either having or not having coronary artery disease. This method of interpreting myocardial images appears worthy of further study.

ST amplitude distributions were studied in 41 patients with acute myocardial infarction by deriving isopotential maps from a 5 x 7 electrode precordial matrix. Independent data on infarct size and localization were obtained utilizing the technetium 99m stannous pyrophosphate scintigraphic method. The locus of maximal ST elevation was stable for at least two days in 86% of 27 patients with anterior infarction. A single maximum or maximum-minimum was found in 88% but 22% of the patients had multiple maxima and/or minima in at least two maps. Areas of significant ST elevation were often excluded from the precordial matrix. The site of maximal ST elevation correlated with scintigraphic infarct site but was displaced medially in lateral infarction. The relation between infarct size and sigmaST elevation was significant and curvilinear. sigmaST underestimated size in large anterior infarction. The correlation of the size and the number of sites with ST elevation greater than or equal to 1.5 mm was weak (r = 0.56). The degree of ST abnormality in 14 patients with inferior infarction decreased significantly during the initial 24 hours. The isopotential maps were similar to those obtained in anterior infarction but the polarity was reversed. The results provide limited support for the continued exploration of ST analysis as a clinical method but suggest that sizing methods should be based on total body surface mapping, taking into account the geometry and electrical properties of the torso.

The haemodynamic effects of prenalterol, a new selective beta-1 adrenoreceptor agonist, have been studied in patients with coronary heart disease. The drug was administered intravenously in a dosage of 0.5 to 2.5 micrograms/kg body weight to 20 patients undergoing coronary angiography and to 10 patients with a recent myocardial infarction, who had clinical evidence of left ventricular dysfunction. Left ventricular performance was enhanced in both groups of patients--left ventricular dP/dt (max) increased by 33 per cent and the systolic time intervals, pre-ejection period, and the ratio of pre-ejection period and left ventricular ejection shortened by 28 and 21 per cent, respectively. Cardiac output and stroke volume increased with no change in heart rate nor in left ventricular filling pressure. These results indicate that prenalterol enhances the contractile state of the myocardium without altering heart rate, and suggest that prenalterol could be of value in the management of patients with coronary heart disease, who have impaired left ventricular function.

Negative staining revealed a tetragonal surface array (S layer) on all the members of a serogroup of Aeromonas hydrophila which possess high virulence for fish. The S layers were similar on all the strains examined, with unit cell dimensions of approximately 12 nm. A single representative strain, strain TF7, was selected for further analysis. Freeze-cleaved and etched preparations and sections for electron microscopy showed that the S layer was the outermost component of the cell envelope. This was confirmed by observation of thin sections. Computer-generated enhancements of the negatively stained micrographs showed the subunit organization to a resolution of less than 4 nm. Two structural units of identical lattice constants alternated in the array in both axes, and one of them was apparently dominant as the center of mass. The lesser unit was rotated 20 degrees from the dominant axes of symmetry and was formed by the junction of linker projections from a corner of the four components of the dominant unit. This interpretation was supported by finding that the array consists of a single polypeptide (molecular weight, 52,000). The unit cell as defined showed p4 symmetry, and a = b = 12.2 nm.

The ability of exercise ECG body surface mapping to detect the presence and distribution of coronary artery disease was investigated in 76 patients presenting with chest pain. The ECG data were recorded from 16 leads regularly placed over the left praecordium. All 16 leads were input simultaneously to a PDP8 computer and 8-second samples were stored at rest, at the termination of symptom-limited exercise, and in the recovery period. ST isopotential surface maps were subsequently constructed. The presence and praecordial projection of ST abnormality were related to the arteriographic distribution of coronary disease. The ECG data were abnormal in 56 of 58 patients with coronary disease and permitted the identification of left anterior descending artery disease in 49 of 53, right coronary artery disease in 39 of 43, and circumflex artery disease in 24 of 30. Mapping separated those with single vessel from those with multiple vessel disease in 91% of patients with coronary disease. These preliminary results suggest that exercise ECG body surface mapping may provide an attractive non-invasive approach to the investigation of patients with coronary disease.

Aquaspirillum itersonii spontaneously produces rhapidosomes. These structures, which are found throughout the cell cycle, are compared with the defective bacteriophage particles that can be induced by mitomycin C treatment (0.5 microgram/mL). The rhapidosomes are composed of three proteins (MW 63 000, 23 500, and 15 000). The defective bacteriophage particles are composed of two proteins (MW 50 000 and 17 500). The defective bacteriophage particles do not react with anti-rhapidosomal protein antiserum. These results indicate that the rhapidosome are not polysheaths of the defective bacteriophage particles inducible in this organism as earlier proposed in the literature. It is concluded that the rhapidosomes of A. itersonii are an assembly of three proteins that are distributed in the cytosol after synthesis and are present at all times in the growth cycle.

A complex and easily disrupted arrangement of macromolecules was present on the outer (lipopolysaccharide) membrane of the cell wall of Spirillum metamorphum. Separation of the arrays from the cell and spontaneous reassembly into regularly structured complexes usually occurred during preparation for electron microscopy. Freeze etchings, thin sections, and optical diffraction analysis of negatively stained fragments indicated that they consisted of two sets of a thin layer which was studied with 3-nm particles arranged in a loose (OL). The OSL consisted of a hexagonal arrangement of 8-nm disks and the OL of a thin layer which was studied with 3-nm particles arranged in a loose rectangular manner. The OSL of reassembled fragments displayed numerous broken delta-linkers between units and a center-to-center spacing of half the expected distance, which suggests that an interdigitation of two OSL arrays had occurred. The observations combined with freeze etchings and thin sections of whole cells suggested a possible reassembly mechanism. The normal surface arrangement of these layers on cells was thought to consist of the OL overlying one set of OSL which was loosely adherent to a thin amorphous backing layer.

The effects of metoprolol, administered in the early stages of acute myocardial infarction was studied in 126 patients. Patients were treated in a double-blind randomized fashion, with metoprolol -15 mg, intravenously followed by 100 mg twice daily for 15 days or placebo, with a mean delay of 8.1 hours from onset of symptoms. All patients underwent 24 hour Holter monitoring on days 1, 5 and 15 after randomization. Although there was no antiarrhythmic effect on day 1, metoprolol reduced the number of hours with warning arrhythmias (greater than 30 ventricular ectopics/hour, any R/T ectopics or ventricular tachycardia) on both days 5 (35 +/- 16% vs 8 +/- 11%; P less than 0.05) and day 15 (13 +/- 37% vs 4 +/- 13%; P less than 0.05). Metoprolol also reduced the incidence of ventricular fibrillation and ventricular tachycardia requiring cardioversion -6% vs 0%; P = 0.058. Metoprolol, administered in the early stages of acute myocardial infarction, had an antiarrhythmic effect which was evident only in the later phase of the study.

The two-layered regular surface array of Aquaspirillum serpens MW5 was removed from cell envelopes and dissociated into subunits by treatment with 6 M urea. The surface components reassembled onto an outer membrane surface and self-assembled into planar sheets in vitro in the presence of Ca2+ or Sr2+. The two layers were removed sequentially from cell envelopes by a two-step extraction procedure involving initial treatment with a high-pH buffer to remove the outermost surface layer and subsequent treatment with 6 M urea to remove the innermost layer. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that the outer and inner layers of the array were composed of two proteins with molecular weights of 125,000 and 150,000, respectively. The two layers assembled sequentially; the 150,000-molecular-weight protein formed an array on an outer membrane surface, and the 125,000-molecular-weight protein required that array as a template for its in vitro assembly.

Two methods are presented that separate the complex envelope of Micrococcus radiodurans, strain Sark, into its constituent layers. The first involved treating whole cells with 0.025 M Tris buffer (pH 7.5) containing 2 mM of calcium and 3 mM of magnesium, resulting in the degradation of an intermediate ('compartmentalized') layer and consequent sloughing of the outer subunit and interior layers to form vesicles. This treatment also appears to show that the interior layer may be connected with the peptidoglycan-containing 'holey' layer. The second method involves treating whole cells with benzene followed by sonication; the results suggested that this treatment only released the outer layers from the 'compartmentalized' layer and did not degrade layers. Following benzene treatment, digestion of the 'compartmentalized' layer with cold sodium dodecyl sulfate (SDS) released the 'holey' layer. Electrophoretic analysis of some of the isolated layer preparations suggested that the subunit layer consisted of three major proteins of 90 000, 92 000, and 94 000 molecular weight, one minor protein of 100 000, a small amount of carbohydrate associated with the 94 000 protein, and a small amount of a 55 000 lipoprotein. The interior layer contained at least 10 proteins and may be attached to the peptidoglycan-containing 'holey' layer by means of the 55 000 lipoprotein.

Urease activity was measured using whole cells of both long (swarming) and short (nonswarming) populations of Proteus mirabilis from casein hydrolysate agar (CHA) and broth (CHB) cultures, and from brain heart infusion broth (BHIB) cultures. Urease is a constitutive enzyme for both long and short cells, but its activity was tremendously increased when urea was incorporated into the media. Urease production was also affected by culture age and media used. Before exponential phase, urease activity was very low, and it increased to its highest point after about 4 h in BHIB and 8 h in both CHA and CHB cultures at 37 degrees C. Long cells had higher urease activity than did short cells when grown on CHA, and was also expressed by two different strains cultured in BHIB. Strain PM23, in BHIB, was able to form long cells (swarming cells) to a maximum proportion after about 4 h, but strain IM47 could not differentiate in any of the liquid media. The former had more urease when swarming differentiation was initiated. PM23 grew relatively faster than IM47 when the former began to differentiate, but this fast growth could not be observed when nutrient broth or minimal medium was used. These observations suggest that long or swarming cells are "faster growing" rather than "nongrowing bacteria".

The influence of beta blockade on the ability of ST depression, during pre-discharge exercise testing, to predict coronary anatomy and subsequent complications was studied in 300 consecutive post-infarct patients, 125 of whom underwent cardiac catheterisation. At the time of exercise 62 patients were taking a beta blocker. The exercise test had a higher sensitivity in predicting multivessel disease in patients who were not taking beta blockers than in patients who were (95% v 76%). beta Blockade did not, however, influence the ability of the test to identify patients at risk of subsequent cardiac events (sensitivity 84% and 85% respectively). These results suggest that it is not necessary to stop treatment with beta blockers before predischarge exercise testing of patients who have had an acute myocardial infarction.

Dopexamine is a novel compound that has DA1-dopaminergic and beta 2-adrenergic agonist properties capable of producing beneficial systemic and renal vasodilation. The acute haemodynamic effects in 10 patients with low-output-state ischaemic cardiac failure (NYHA IV) were recorded before (control) and during graded incremental doses of dopexamine infusion from 0.5 to 6.0 micrograms/kg/min. Dopexamine produced a marked increase in cardiac index from 1.6 +/- 0.2 (control) to a maximum of 2.8 +/- 0.4 L/min/m2 (p less than 0.001) primarily by inducing vasodilation, with reduction in systemic vascular resistance from 1,720 +/- 136 (control) to 1,116 +/- 136 dynes.s.cm-5 (p less than 0.05). Using a more sophisticated analytical technique which enables us to separate direct inotropic from vasodilatory effects, we were able to identify, in eight of the patients, a direct dopexamine-induced positive inotropism. These beneficial central haemodynamic effects of dopexamine, when coupled with its known DA1-dopaminergic agonist property, indicate that dopexamine may have a place in the management of patients in severe heart failure.