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Two-by-two sequence alignment revealed that the levels of homology between 16S rRNA gene sequences of strains belonging to the two biovars of Ureaplasma urealyticum (class Mollicutes) ranged from 98.5 to 98.9%. Within the biovars, three serovars of the T960 biovar exhibited levels of homology of > or = 99.7%, and the four serovars of the parvo biovar exhibited levels of homology of > or = 99.7%. A dendrogram of the Mycoplasma pneumoniae-Ureaplasma clade of the Mollicutes reflected the distinctiveness of the biovars.

Central administration of thyrotropin-releasing hormone (TRH) produces a short-lived antinociceptive response in rats, and also modulates opioid and non-opioid forms of antinociception. Given the presence of TRH cells, fibers and receptors in the periaqueductal gray (PAG), the present study examined the effects of TRH administered into the PAG upon antinociception following either continuous cold-water swims (CCWS, 2 degrees C for 3.5 min) or morphine (0.1-2.5 micrograms) administered into the PAG on the tail-flick and jump tests, and measured changes in core body temperatures as well. Histological examination revealed two groups in which anterior PAG placements were found rostral to the dorsal raphe nucleus, and posterior PAG placements which were at the level of this nucleus. TRH produced brief (5-15 min) but significant increases in latencies and thresholds without altering body temperature in both anterior and posterior PAG placements. Whereas TRH in anterior PAG placements dose dependently (0.1-10 micrograms) decreased CCWS antinociception on both tests, TRH in posterior PAG placements significantly increased CCWS antinociception on the jump test. TRH in both placements reduced the magnitude of CCWS hypothermia. TRH significantly potentiated the magnitude and duration of both morphine antinociception and hyperthermia in both anterior and posterior PAG placements, and shifted mesencephalic morphine's antinociceptive dose-response curve significantly to the left. These data are discussed in terms of the role of the PAG in opioid and non-opioid forms of stress-induced antinociception as well as morphine antinociception, and in terms of the roles of TRH and anterior PAG placements as potential candidates for a collateral inhibition model of antinociceptive responses.

The Pittsburgh protocol is ethically and legally acceptable as written, but more research is needed to determine if it can be implemented in ways that will observe the procedures that make it ethically acceptable. If so, its desirability as public policy will depend on the number of organs it is likely to generate and its effects on public attitudes toward organ donation generally. In the final analysis, the controversial aspects of this protocol concern symbolic issues about respect for the dead and near dead, rather than substantive concerns that real patient interests will be harmed.

Several fundamental phenotypic and genotypic differences have separated strains of the genital mycoplasma Ureaplasma urealyticum into two clusters or biovars. However, the lack of an easily performed and unambiguous test to discriminate between them has hampered investigation of the relationship between these biovars and disease. We determined the 16S rRNA nucleotide sequence of U. urealyticum 27, the serovar 3 standard and representative of the parvo biovar (serovars 1, 3, 6, and 14). This sequence was compared with the published sequence of U. urealyticum T960, which is the type strain and the serovar 8 standard and is representative of the T960 biovar which is composed of the 10 intervening serovars. Homology between the two sequences was 98.8%; differences were exploited to provide primers for biovar-specific polymerase chain reactions (PCRs). The results of these reactions placed all 14 serovar standard strains into the correct biovar. The PCRs were also applied to 10 cloned and 8 noncloned isolates that had been serotyped earlier. For 16 of them, we deduced their biovars from the serotyping data and then confirmed them by PCR. One unpredictable isolate and one nonserotypeable isolate were also classified as to biovar. Thus, we have developed a method for biotyping U. urealyticum that is applicable to both laboratory-adapted strains and wild-type isolates and that is appropriate for testing large numbers of clinical isolates. The amplification by the T960 biovar PCR protocol of DNAs from ureaplasmas of animals and certain Mycoplasma species suggested that the parvo biovar has diverged from the mainstream of the evolution of this clade.

"OBJECTIVE--To compare the efficacy of home based care with standard hospital care in treating serious mental illness. DESIGN--Randomised controlled trial. SETTING--South Southwark, London. PATIENTS--189 patients aged 18-64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated. MAIN OUTCOME MEASURES--Use of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff. RESULTS--Home care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non-significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval--1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme. CONCLUSIONS--Home based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required."

Legal and ethical issues involving genetics arise at the level of carrier screening, preimplantation diagnosis in embryos and prenatal diagnosis in fetuses. A strong commitment to procreative liberty and autonomy should permit patients and physicians to gain access to genetic information at every stage of decision making. Even if Roe v Wade is reversed, considerable room for the use of genetic information in procreative decision making will remain.

The development of in vitro fertilization has led to ethical and legal controversies concerning actions with externalized preembryos. A legal and ethical consensus is emerging that preembryos are not legal persons or moral subjects, although they are owed special respect because of their ability to implant and come to term. In addition, gamete providers are recognized as having dispositional authority over whether preembryos will be created, cryopreserved, placed in a uterus, discarded, donated, or used in research. Prior agreements over preembryo disposition are the best way to minimize disputes between the gamete providers.

If preembryos are not persons, as Professor Richard A. McCormick recently argued in an article in this journal, then a variety of actions with preembryos should be permitted to follow. These actions include discard, freezing, research, and preimplantation genetic analysis.

Advance directives such as living wills are attractive in that they give us a sense of control over our futures. But they also tend to obscure conflicts between a patient's competent wishes and later, incompetent interests. They allow caregivers to avoid evaluating quality of life in assessing the best interests of incompetent patients.

Persistent infectious polyarthritis caused by Ureaplasma urealyticum in a patient with common variable hypogammaglobulinaemia is described. The patient developed a symmetrical, destructive polyarthritis and tenosynovitis associated with a markedly depressed synovial fluid glucose concentration and characteristic soft tissue abscesses. The ureaplasma organism developed resistance to multiple antibiotics and persisted for five years. The organism was identified repeatedly in many joints by culture, confirmed by DNA hybridisation, and mycoplasma-like structures were shown in synovial tissues by electron microscopy.

"This paper discusses the advantages and disadvantages of case management systems for the co-ordination of care of people with long-term mental illness living in the community. Many of the principles are equally applicable to other client groups with long-term needs, e.g. elderly people or people with learning difficulties. Some of the historical background to the emergence of case management concepts is discussed, culminating in the recent White Paper on Community Care. The underlying concept of case management is examined, together with a number of fundamental questions concerning who should act as case managers, what kinds of training they will require, problems of inter- and intra-agency co-operation, and the empirical evidence regarding its effectiveness. It is concluded that case management could be an important element in a comprehensive range of mental health services, but it is not a substitute for basic community provisions."

Hemadsorption by colonies of Ureaplasma urealyticum and Mycoplasma pneumoniae differed quantitatively and qualitatively. Using standard methodology, few strains of U. urealyticum hemadsorbed; with a modified method, most strains hemadsorbed, indicating a second type of association. Scanning electron microscopy of tannin-osmium-stained preparations showed guinea pig erythrocytes embedded in ureaplasma colonies and craters left when erythrocytes were dislodged.

The sizes of the genomes of 12 Ureaplasma strains isolated from six mammalian and one avian species, as determined by pulsed-field gel electrophoresis, varied from 760 to 1,170 kilobase pairs (470 to 723 megadaltons); and these values encompassed the values for the genomes of Ureaplasma urealyticum strains. Variation of at least 54% in the genome sizes restricts the usefulness of this taxonomic criterion for the genus Ureaplasma.

Cultures of Mycoplasma hyopneumoniae and M. flocculare in Friis' broth grew faster and to higher titers in air than in 8% CO2; cultures in air grew better when shaken than when stationary. Under the optimal conditions, both species have generation times of about 10 h and achieve maximum titers of at least 10(9) organisms per ml. Maximum growth was reached near pH 7.0, before the phenol red indicator had noticeably changed colour. Changes in growth were readily detected by an ATP assay based upon the luciferin-luciferase reaction. Concentrations of ATP fell rapidly after peak growth. Although the addition of 27 mM glucose to the medium did not change the pattern of growth and gas chromatography gave no evidence of the production of volatile or non-volatile end-products, washed harvested cells of both species metabolized [14C]-glucose. The addition of 29 mM arginine to the medium inhibited growth.

The female-specific expression of the rat liver PRL receptor (PRL-R) gene was investigated by Northern analysis of hypophysectomized rats after two alternative human GH treatments that were to mimic either 1) the continuous female-specific or 2) the discontinuous male-specific serum GH patterns. The former (female-specific) pattern was shown to result in a dramatic increase in PRL-R mRNA in both males and females, while the latter (male-specific) pattern failed to evoke this response. A similar inductive effect in hypophysectomized females was shown after continuous administration of bovine GH and was found to constitute an approximately 60-fold increase in PRL-R mRNA levels. This effect by bovine GH, which, unlike the human isoform, is devoid of lactogenic properties, thus indicates the somatogenic origin of the signal resulting in this inductive response. These observations in conjunction with previous data obtained for other GH-regulated nonreceptor genes are interpreted to support the proposal of GH serum patterns being an early signal in a more general mechanism for pretranslational regulation of sex-specific gene expression. In contrast to GH, only a slight elevation of PRL-R mRNA was evoked by the ligand ovine PRL, while coadministration of ovine PRL with bovine GH failed to enhance the mRNA level found with bovine GH alone. The detection of previously unreported PRL-R mRNAs in liver of approximately 3.0, 3.8, and 5 kilobases in addition to the major 2.2-kilobase form was also evident after continuous GH administration.

Contour clamped homogeneous field (CHEF) agarose gel electrophoresis (AGE), ramped to give linear separation of DNA molecules of 600-1600 kilobase pairs (kbp), was used to determine mobilities for full-sized genomic DNA of the serotype standard strains of the human genital mollicutes, Ureaplasma urealyticum relative to yeast chromosomal DNA markers. Indicated genome sizes (in kbp) were 760 for the four biotype 1 strains and 840-1140 for eleven biotype 2 strains. Other estimates were: 720 for Mycoplasma hominis, 1070 for Mycoplasma hyopneumoniae, 890 for Mycoplasma flocculare, 1180 and 1350 for Mycoplasma mycoides subsp. mycoides Y and GC1176-2, respectively, and 1650 and 1580 for Acholeplasma laidlawii B and PG 8, respectively. These data supplement previous evidence from CHEF AGE that the genomes of the Mycoplasmataceae are diverse in size with some larger than previously estimated from DNA renaturation kinetics.

Complementary DNA clones encoding the male-specific rat liver cytochrome P-450 g have been isolated by cross-hybridization with sequences from the female-specific rat liver cytochrome P-450 15 beta. Tissue distribution analysis indicates the liver as the organ with major expression of this cytochrome P-450 gene. Minimal P-450 g expression was also detected in prostate, kidney, heart, and brain. A developmental analysis reveals liver expression in the 8-week-old male and to a lesser extent in the 4-week-old male, but no detectable expression is seen in females of these ages or in 1- and 2-week-old rats from both sexes. Hypophysectomy of female rats dramatically increases hepatic expression of P-450 g, whereas continuous GH administration represses hepatic expression in male or female hypophysectomized rats. In similarity to P-450 15 beta and P-450 16 alpha, therefore, the cytochrome P-450 g gene in liver is GH regulated.

The amount of larynx seen at intubation was assessed in 633 adult patients undergoing routine surgery. Various measurements of the head and neck were made in an attempt to discover which features were associated with difficulty with laryngoscopy (defined as the inability to see even the arytenoids). In addition 38 patients, reported by colleagues because they had been "difficult to intubate", were measured. Five useful risk factors, measured at three levels of severity, were identified. A simple predictive rule was developed and tested on a prospective set of 778 patients, in 1.5% of whom laryngoscopy was found to be difficult. Depending on the threshold chosen, the rule allowed the detection of, for example, 75% of the "difficult" laryngoscopies at a cost of falsely identifying 12% of the "not difficult" patients.

Since their exodus in 1959 about 100,000 Tibetans have settled in disparate communities in northern India and Nepal. This study describes the dental health of 243 Tibetan children in Dharamsala, in the State of Himachal Pradesh, India. Only 20% of 6-yr-olds were caries-free in the primary dentition while 96.9, 53.3, and 22.4% of 6, 12, and 15-yr-olds were caries-free in the permanent dentition respectively. The DMFT of 12-yr-old children was 1.1, while 15-yr-old children had a DMFT of 3.1. While plaque and calculus were present in many sextants, there was little intense gingivitis and signs of advanced periodontal diseases were rarely present. Almost no dental care had been received. Appropriate dental health promotion activities are discussed.

Many common devices can be used as biofeedback devices. The feedback use of the bathroom scale in rehabilitation medicine (physical therapy) has been explored with stroke patients. These patients used two scales, one under each foot, to relearn their sense of weight distribution. In addition, the scale was used to teach patients to shift their weight distribution from their knees to their hands as they learned to crawl, and from their feet to their buttocks and the chair as they learned to sit down.

All of 14 serotype standards and 34 of 35 wild-type strains of Ureaplasma urealyticum isolated from humans demonstrated an immunoglobulin A (IgA) protease activity. This activity degraded radiolabeled human IgA including IgA1 but not IgG or azocasein. The IgA fragments were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, followed by radioautography, and they had molecular weights of about 110,000 and 50,000. The IgA protease activity persisted in 25 mM EDTA but was sensitive to trypsin; it was presumed to be protein. This is the fourth microbial genus and the first myocoplasma species in which an IgA protease activity has been identified. Such activity was absent in Mycoplasma pneumoniae, Mycoplasma hominis, and Acholeplasma laidlawii.

1. Dietary fibre has a water holding capacity (WHC) and this is a function of the fibre source and method of measurement. Water can be associated with fibre either as trapped water or bound water. This makes it difficult to predict the ability of fibre to influence stool weight in humans. 2. Examination of various fibre concentrates for chemical composition, as neutral detergent fibre (NDF), acid detergent fiber (ADF) and lignin; structure, by scanning electron microscopy; WHC, by centrifugation, suggests that WHC is more a function of fibre structure than chemical composition. Cereal fibre and vegetable fibre have a different chemical composition and are structurally very distinct. Structure is also dependent on the method of fibre preparation. 3. Measurement of WHC by centrifugation gives an estimate of the water which can be bound and also trapped by the fibre. The amount of trapped water will depend on the structure of the fibre whereas bound water will depend on the chemical composition.