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Background. Although there is evidence that buprenorphine is more effective than placebo in suppressing heroin use, and is a recommended treatment for opioid dependence, methadone remains the dominant maintenance treatment. However, this may have adverse consequences in increased dependence liability and greater withdrawal effects. Rationale. The study assessed the experiences of clients in Lanarkshire who had experienced both substances to report on the strengths and weaknesses of each. Method. Two phases of opportunistic data were collected -- open narrative accounts of those successfully detoxifying from Suboxone (a buprenorphine//naloxone combination) and structured interviews with clients comparing Suboxone and methadone. Results. Consistently, clients reported more clarity of thinking while on Suboxone. However, this was not always perceived positively as increased clarity necessitated more psychosocial therapeutic support than was needed on methadone. Suboxone was associated with increased confidence and lower stigma than methadone. Concerns were expressed about the antagonistic effect of Suboxone, with several reports of ''use on top''. Conclusion. Participants made clear distinctions between methadone and Suboxone, with the strongest difference being increased clarity of thinking on Suboxone. Suboxone has significant potential for staged use within a ''recovery journey'' but only if prescribed within an appropriate package of psychosocial care. [ABSTRACT FROM AUTHOR]

GILL TANNER discusses the issues that practitioners working in urgent care must consider when treating wounds in patients who self harm. [ABSTRACT FROM AUTHOR]

Barrett's epithelium is a recognized premalignant condition for esophageal adenocarcinoma. Nonsteroidal antiinflammatory drugs (NSAIDs) decrease the relative risk of colon cancer in humans and the esophageal tumor load in carcinogen-treated mice. Previous studies provided conflicting results for COX-2 activity in Barrett's mucosa. Pinch mucosal biopsies were collected from Barrett's and adjacent normal esophageal mucosa from 17 patients with Barrett's esophagus. Low-grade dysplasia was found in seven patients. COX-2 protein was undetectable in normal esophageal mucosa. COX-1 protein expression did not vary between normal and Barrett's epithelium. Increased COX-2 protein was detected in Barrett's epithelium in seven patients (41%) but did not differ with or without dysplasia (43% vs 40%). In conclusion, COX-2 protein is increased in 41% of patients with Barrett's epithelium compared to normal esophageal mucosa but did not differ with or without dysplasia. COX-2 induction may be an early event in the development of Barrett's esophagus. [ABSTRACT FROM AUTHOR]

We present a case report of total knee arthroplasty complicated by spasticity and contractures in a patient with multiple sclerosis (MS). Four previous case reports in the literature describe adverse outcomes after total knee arthroplasty in persons with MS secondary to severe spasticity. Preoperative, intraoperative, and postoperative considerations for persons with MS, which may help to improve functional outcomes, are discussed. Prospective research is needed among persons with MS to help determine the timing and selection of persons for arthroplasty and to minimize complications related to spasticity.

Fructan:fructan fructosyltransferase (FFT) activity was purified about 300-fold from leaves of Lolium rigidum Gaudin by a combination of affinity chromatography, gel filtration, anion exchange and isoelectric focusing. The FFT activity was free of sucrose: sucrose fructosyltransferase and invertase activities. It had an apparent pI of 4.7 as determined by isoelectric focusing, and a molecular mass of about 50000 (gel filtration). The FFT activity utilized the trisaccharides 1-kestose and 6G-kestose as sole substrates, but was not able to use 6-kestose as sole substrate. The FFT activity was not saturated when assayed at concentrations of 1-kestose, 6G-kestose or (1,1)- kestotetraose of up to 400 mM The rate of reaction of the FFT activity was most rapid when assayed with 1-kestose and was less rapid when assayed with 6G-kestose, (1,1 )-kestotetraose or (1,1,1 )-kestopentaose. The FFT activity when assayed at a relatively high concentration of enzyme activity (approximately equivalent to about half the activity in crude extracts per gram fresh mass) did not synthesize fructan of degree of polymerization > 6, even during extended assays of up to 10 h. When assayed with a combination of 1-kestose and uniformly labelled [14C]sucrose as substrates, the major reaction was the transfer of a fructosyl residue from 1-kestose to sucrose resulting in the re-synthesis of 1-kestose. Tetrasaccharide and 6G-kestose were also synthesized. When assayed with 6G-kestose and [14C]sucrose as substrates, the major reaction of the FFT activity was the synthesis of tetrasaccharide. However, some synthesis of 1-kestose and re-synthesis of 6G-kestose also occurred. When 6Gkestose was the sole substrate for the FFT activity, synthesis of tetrasaccharide was 2.7 to 3.4-fold slower than when 1-kestose was used as the sole substrate. Owing to differences in the fructan : sucrose fructosyltransferase acitity of the FFT with each of the trisaccharides, net synthesis of tetrasaccharide by the FFT was altered significantly in the presence of sucrose. The magnitude of the effect depended on the concentration of the trisaccharides. In the presence of sucrose, 6Gkestose could be a substrate of equvalent importance to 1-kestose for synthesis of tetrasaccharide. [ABSTRACT FROM AUTHOR]

This paper reports on the production of intergeneric somatic hybrid plants between two sexually incompatible legume species. Medicago sativa (alfalfa, lucerne) leaf protoplasts were inactivated by lethal doses of iodoacetamide. Onobrychis viciifolia (sainfoin) suspension-cell protoplasts were gamma-irradiated at lethal doses. Following electrofusion under optimized conditions about 50,000 viable heterokaryons were produced in each test. The fusion products were cultured with the help of alfalfa nurse protoplasts. Functional complementation permitted only the heterokaryons to survive. A total of 706 putative heterokaryon-derived plantlets were regenerated and 570 survived transplantation to soil. Experimentation was aimed at the introduction of proanthocyanidins (condensed tannins) from sainfoin, a bloat-safe plant, to alfalfa, a bloat-causing forage crop; however, no tannin-positive regenerant plants were detected. Most regenerant plants have shown morphological differences from the fusion parents, although, as expected, all resembled the 'recipient' parent, alfalfa. Southern analysis using an improved total-genomic probing technique has shown low levels of sainfoin-specific DNA in 43 out of 158 tested regenerants. Cytogenetic analysis of these asymmetric hybrids has confirmed the existence of euploid (2n=32; 17%) as well as aneuploid (2n=30, 33-78; 83%) plants. Pollen germination tests have indicated that the majority of the hybrids were fertile, while 35% had either reduced fertility or were completely sterile. [ABSTRACT FROM AUTHOR]

Spartina alterniflora culms dug from a naturally established seedling stand, and from tall- and dwarf-form stands were transplanted on a coarse (Area I) and a fine textured (Area II) substrate of similar elevation. Soil amendment treatments of 122.0 and 244.0 kg ha each of inorganic N, PO and KO and a commercial root dip treatment were applied to the three culm types. The seedling culm type was the superior transplant material in terms of initial survival, rapid tiller production and below-ground biomass accumulation. The dwarf- and tall-form culms were from more mature stands and did not have a comparable flush of growth. Although initial transplant survival was slightly less in Area II, vegetative growth of all three culm types was more rapid than on the coarse textured substrate. Increased water holding capacity and nutrient availability of the fine textured substrate probably reduced osmotic stress between tidal inundation in the summer months and promoted growth throughout the year. At 16-mo postplanting, only the seedling culms were similar to natural stands in the vicinity in terms of culm density. Root: shoot ratios of less than unity for all culm types indicated the stand was still developing. [ABSTRACT FROM AUTHOR]

Lucerne (alfalfa - Medicago sativa) pollen, cultured at the late unicellular stage, followed one of two developmental pathways: (1) A pathway involving symmetric mitosis which produces pollen containing two vegetative (2 V) or two generative (2 G) pollen. This morphology was only observed in culture, and pollen which followed this developmental path is defined as non-physiological. Occasionally the formation of multi-nucleate pollen grains containing from 4-9 cells were observed. Sustained divisions were not observed. (2) The production of bicellular (V+G) pollen followed by tricellular (V+2G) pollen. Since these types of grains are encountered during development in vivo, pollen following this developmental pathway is defined as physiological. The proportion of pollen that divided was enhanced by a cold treatment at 4°C for one week, prior to culture. The ratio of non-physiological (i.e., 2V or 2G) to physiological pollen (G+V or 2G+V) was found to be affected by the nature of the osmoticum in the medium. Media containing maltose or melibiose gave higher proportions of non-physiological pollen than media containing glucose or sucrose. Culture of detached anthers favoured the formation of 2G pollen whereas culture of whole buds favoured the development of 2V pollen. The ratio of non-physiological to physiological pollen after 1 week of culture was used as a criterion for identifying protocols and media which may be more suitable for inducing sustained cell division in lucerne microspores. [ABSTRACT FROM AUTHOR]