Heterogeneity in chronic fatigue syndrome: evidence from magnetic resonance spectroscopy of muscle.

It has been shown previously that some patients with chronic fatigue syndrome show an abnormal increase in plasma lactate following a short period of moderate exercise, in the sub-anaerobic threshold exercise test (SATET). This cannot be explained satisfactorily by the effects of 'inactivity' or 'deconditioning', and patients with abnormal lactate responses to exercise (SATET +ve) have been found to have significantly fewer Type 1 muscle fibres in quadriceps biopsies than SATET -ve patients. We performed phosphorus magnetic resonance spectroscopy on forearm muscles of 10 SATET +ve patients, 9 SATET -ve patients and 13 sedentary volunteers. There were no differences in resting spectra between these groups but at the end of exercise, intracellular pH in the SATET +ve patients was significantly lower than in both the SATET -ve cases and controls (P < 0.03), and the SATET +ve patients also showed a significantly lower ATP synthesis rate during recovery (P < 0.01), indicating impaired mitochondrial oxidative phosphorylation. These observations support other evidence which indicates that chronic fatigue syndrome is a heterogeneous disorder, and confirms the view that some chronic fatigue syndrome patients have a peripheral component to their fatigue.

Pathology of the iridocorneal-endothelial syndrome. The ICE-cell.

PURPOSE: The iridocorneal-endothelial (ICE) syndrome is characterized by glaucoma, corneal failure, and iris destruction. Specular photomicroscopy of the corneal endothelium in this disease shows a population of abnormal cells named ICE-cells. Comparison between ultrastructural examination and specular photomicroscopy demonstrates that the histologic equivalent of ICE-cells are cells with an epithelial phenotype. The authors have studied the differentiation markers expressed by ICE-cells using an ultrastructural immunocytochemical technique. METHODS: Seven keratoplasty specimens from patients with the ICE syndrome were examined by scanning and transmission electron microscopy and light and electron microscopic immunocytochemistry. Comparison was made with three normal corneas. Immunocytochemical studies were performed with monoclonal antibodies to broad-spectrum cytokeratins, cytokeratins 3, 5/8, 8/18 and 19, vimentin, and epithelial membrane antigen. RESULTS: ICE-cells were morphologically similar to epithelial cells and expressed the same profile of differentiation markers as did normal limbal epithelial cells. CONCLUSIONS: ICE-cells may arise from an embryologic ectopia of ocular surface epithelium. Alternatively, these findings are consistent with a metaplastic stimulus resulting in a profound change in the phenotype of normal corneal endothelial cells.

Testosterone deficiency myopathy.

Testosterone is recognized to have a positive effect on nitrogen balance and muscle development in hypogonadal men, but significantly myopathy secondary to testosterone deficiency has been reported only rarely. We describe a patient who presented with a myopathy associated with testosterone deficiency, and who demonstrated a significant functional and myometric response to treatment.

Self-concept and attitudes toward adoption: a comparison of searching and nonsearching adult adoptees.

This study showed that nonsearchers and searchers are different from each other on almost every measure that was applied. Research on and experience with searching adult adoptees should not be applied to nonsearching adult adoptees. Likewise, research on and experience with nonsearching adult adoptees should not be generalized to searchers . The results of this study do not support the belief that adoptees, in general, have low self-concepts and identity conflicts, or that adoptees need information about their biological families and reunions to resolve their identity conflicts. Although the sample of pre- and post-reunion searchers was small, reunions did not make a significant difference in self-concept or identity conflicts, as measured by the TSCS . The results of this study do not support the theoretical bases often cited to justify open records. Specifically, adult adoptees in this study do not have negative self-concepts, did not experience poor adoptor - adoptee relationships, and the majority did not experience revelation of adoptive status as disruptive or late. Although significant differences exist between the comparison groups, an important finding is that of all the adult adoptees, the majority scored above the sixtieth percentile on the TSCS and had positive scores on the Attitude Toward Parents Scales. Furthermore, they were happy growing up, with only 12% reporting being unhappy. These findings support the conclusions of Day [1979] and Norvell and Guy [1977] as well as the belief that adoption is a legitimate way of building families.(ABSTRACT TRUNCATED AT 250 WORDS)

Stresses and strains on the child care worker: typologies for assessment.

Recent literature in the field emphasizes both organizational and personal stresses on the child welfare worker. This paper examines in detail the factors involved.

Rates of induction of mitochondrial aldehyde dehydrogenase in rat liver.

Aldehyde dehydrogenase activities in liver mitochondria isolated from rats given ethanol at hourly intervals by gastric intubation showed a brief lag period followed by a rapid increase in specific activities until a maximum was attained at about 3h.

The reaction of choline dehydrogenase with some electron acceptors.

1. The choline dehydrogenase (EC 1.1.99.1) WAS SOLUBILIZED FROM ACETONE-DRIED POWDERS OF RAT LIVER MITOCHONDRIA BY TREATMENT WITH Naja naja venom. 2. The kinetics of the reaction of enzyme with phenazine methosulphate and ubiquinone-2 as electron acceptors were investigated. 3. With both electron acceptors the reaction mechanism appears to involve a free, modified-enzyme intermediate. 4. With some electron acceptors the maximum velocity of the reaction is independent of the nature of the acceptor. With phenazine methosulphate and ubiquinone-2 as acceptors the Km value for choline is also independent of the nature of the acceptor molecule. 5. The mechanism of the Triton X-100-solubilized enzyme is apparently the smae as that for the snake venom solubilized enzyme.

Essentiality of ubiquinone for choline oxidation in rat liver mitochondria.

Rat liver mitochondria treated extensively with n-pentane are incapable of oxidizing choline. Choline oxidation is more sensitive than is succinate oxidation to serial n-pentane extraction of mitochondria. The ability to oxidize choline is restored by the addition of ubiquinone-2 or ubiquinone-10 to the oxidase assay medium.

Induction of mitochondrial aldehyde dehydrogenases in livers of senescent rats.

Senescent rats were administered ethanol by gastric intubation at hourly intervals. After 1 h, there was a rapid increase in the specific activities of two isoenzymes of liver mitochondrial aldehyde dehydrogenase which was sustained for the next 2 h. No further changes were observed during the course of the following 2 h.

Content of a cross-reactive idiotype in nonimmune A/J sera.

The anti-p-azophenylarsonate antibodies of A/J mice express a major intrastrain cross-reactive idiotype (CRIA). Using a sensitive radioimmunoassay we were unable to detect significant quantities of molecules bearing CRIA in nonimmune A/J sera. The upper limit is 140 ng/ml. Possible reasons for variability of such data in the published literature are discussed.

Career patterns and job satisfaction of Canadian nurse educators.

The purpose of this study was to describe the career patterns and job satisfaction of Ontario university and college nurse educators. A descriptive survey design was employed using mailed questionnaires. The sample comprised 60 nurse educators, 30 from three universities and 30 from three colleges. Forty-four returned the completed questionnaire, giving a response rate of 73%. The variables about the career patterns and goals of the nurse educators included their past and present job satisfaction. Career patterns were described as stable, double-track, interrupted and unstable. Similarities and differences were compared and described in relation to these factors. Significant differences in job satisfaction were found between university and college faculty on nine of the 36 job characteristics (for example, leadership style, independence, autonomy and salary). There were no significant differences in job satisfaction for each of the career patterns and the selected demographic variables of age, years in nursing education, educational level and salary between the university and college faculty.

Lowered respiratory activity in hypo-osmotically shocked mitochondria without loss of cytochrome c.

Brief exposure of rat liver mitochondria to hypo-osmotic sucrose media caused a decline in the rates of succinate and ascorbate-NNN'N'-tetramethyl-p-phenylenediamine oxidation without loss of cytochrome c when assayed in iso-osmotic media. Lowered respiration rates in mitochondria after brief exposure to hypo-osmotic media may reflect a modification of cytochrome c binding.

Hydronephrosis: prevention by restoration of urinary concentrating ability using desamino-8D-arginine vasopressin (DDAVP) in Brattleboro rats.

Male Brattleboro rats with hereditary diabetes insipidus (BDI) were lifetime-treated with the vasopressin V2 receptor agonist desamino-8D-arginine vasopressin (DDAVP), given daily in the drinking fluid. The DDAVP-treated adult male BDI rats drank 34 +/- 6 ml/24 h (mean +/- s.e.m.) and excreted urine volumes of 22 +/- 5 ml/24 h compared with their age-matched untreated controls of 142 +/- 12 and 115 +/- 7 ml/24 h respectively. There was no significant difference between the mean body weights of chronically DDAVP-treated BDI rats (198 +/- 9 g) and untreated animals (207 +/- 9 g). Morphometry of sections of kidney confirmed extensive hydronephrosis in the right kidneys of the control untreated Brattleboro rats only. This was quantified as the area of pelvis expressed as a percentage of total cross-sectional area of kidney (17 +/- 3 compared with 5 +/- 1% in the chronically DDAVP-treated rats; P less than 0.002). Medium-term treatment of adult BDI rats with DDAVP reduced daily fluid output towards normal rat values but hydronephrosis was still present. These observations indicate that the restoration of fluid balance in adult BDI rats by treatment from conception with DDAVP may be an important factor in preventing the development of hydronephrosis in these animals.

Evaluating the graduates of the Dalhousie University School of Nursing baccalaureate programme: a quantitative/qualitative responsive model.

The purpose of this study was to determine if the Dalhousie University School of Nursing's curriculum enabled its graduates to meet the terminal objectives of the programme and to determine if these objectives were consistent with the requirements of their employers. An explorative, descriptive design using qualitative and quantitative data were employed through a mailed survey and employer focus groups. Stufflebeam's model served as the conceptual framework to guide this product evaluation. The setting for this study was a baccalaureate school of nursing and eight employing agencies in eastern Canada. A total of 190 graduates were sampled comprising basic and post-RN graduates from the class of 1989 to 1991 inclusive. The response rate was 40.5% (n = 77). Analysis of data included frequency and percentage calculations and thematic descriptions of employer and graduate responses. Findings of this study indicated that the graduates and their respective employers rated the nursing programme to be very satisfactory. Implications for curriculum accountability are discussed.

Experimental interstitial renal fibrosis in rats: nephritis induced by N-(3,5-dichlorophenyl)succinimide.

The nephrotoxic properties of the chemical N-(3,5-dichlorophenyl)-succinimide were investigated in rats with a view to establishing the usefulness of this chemically-induced nephritis as a model of chronic interstitial renal fibrosis. The compound was synthesized and given daily by gastric intubation as a suspension in arachis oil B.P. to male WAG-strain rats, for periods of up to 108 days. Polydipsia and polyuria resulted rapidly in all treated animals and persisted for the duration of the experiment. There was a progressive increase in the extent of proteinuria in all treated animals and, by the end of the experiment, there was an increase in the plasma levels of urea and creatinine. Short term treatment (up to 3 days) resulted in focal areas of necrosis of some proximal convoluted tubules. Treatment for 28 days resulted in patchy but severe tubular interstitial nephritis with which was associated a moderate interstitial fibrosis. By 108 days, the nephritis was more widespread and the interstitial fibrosis was severe. The activity of proline hydroxylase, a part of the intracellular sequence of collagen synthesis, showed progressive increase in the renal cortex throughout the experiment and there was an associated increase in the cortical hydroxyproline content, a measure of the amount of collagen present. Associated with this biochemical evidence of an active, chronic fibrosis, was an increased water content of the cortical tissue. The results indicate that this chemically-induced, tubular interstitial nephritis is indeed a good and reliable model of interstitial renal fibrosis.

Cryofibrinogenaemia and acute gangrene in systemic sclerosis.

A 49 year old man with systemic sclerosis developed ischaemia of his extremities with massive peripheral gangrene. High levels of circulating cryofibrinogen were detected in the plasma and the significance of these findings is discussed.

Muscle fibre characteristics and lactate responses to exercise in chronic fatigue syndrome.

OBJECTIVES: To examine the proportions of type 1 and type 2 muscle fibres and the degree of muscle fibre atrophy and hypertrophy in patients with chronic fatigue syndrome in relation to lactate responses to exercise, and to determine to what extent any abnormalities found might be due to inactivity. METHODS: Quadriceps needle muscle biopsies were obtained from 105 patients with chronic fatigue syndrome and the proportions of type 1 and 2 fibres and fibre atrophy and hypertrophy factors were determined from histochemical preparations, using a semiautomated image analysis system. Forty one randomly selected biopsies were also examined by electron microscopy. Lactate responses to exercise were measured in the subanaerobic threshold exercise test (SATET). RESULTS: Inactivity would be expected to result in a shift to type 2 fibre predominance and fibre atrophy, but type 1 predominance (23%) was more common than type 2 predominance (3%), and fibre atrophy was found in only 10.4% of cases. Patients with increased lactate responses to exercise did have significantly fewer type 1 muscle fibres (p<0.043 males, p<0.0003 females), but there was no evidence that this group was less active than the patients with normal lactate responses. No significant ultrastructural abnormalities were found. CONCLUSION: Muscle histometry in patients with chronic fatigue syndrome generally did not show the changes expected as a result of inactivity. However, patients with abnormal lactate responses to exercise had a significantly lower proportion of mitochondria rich type 1 muscle fibres.

Competitive idiotype--anti-idiotype immunoassay for adenosine deaminase binding protein in urine.

This competitive immunoassay, based on inhibition by antigen of the idiotype-anti-idiotype interaction, detects adenosine deaminase binding protein (ABP), and involves use of monoclonal anti-idiotype antibodies prepared to a monoclonal antibody specific for ABP. The conditions for this new type of competitive immunoassay are investigated. This competitive immunoassay is as sensitive and reproducible as an earlier described "sandwich"-type immunoassay for ABP (Clin Chem 31: 679-683, 1985). Evaluation of urine samples from normal subjects and from patients showed increased concentrations of ABP in patients with renal disease.

Characterization of a promoter for gamma-glutamyl transpeptidase activated in rat liver in response to aflatoxin B1 and ethoxyquin.

gamma-Glutamyl transpeptidase (GGT) is normally absent from adult rat hepatocytes but is induced by a range of xenobiotics, including carcinogens and chemoprotective agents. As many as six mRNA species for this enzyme have been described in both rat and mouse, with various degrees of tissue specificity. These originate from one gene and have separate promoters within alternative 5' untranslated sequences. By using a cDNA-derived sequence specific for GGT mRNA III to screen a rat genomic library, a clone that contains the promoter region for this mRNA was isolated and characterized. The transcriptional start site lay some 3.5 kb upstream from that already characterized for mRNA II in rat kidney. Luciferase activity was obtained after transfection of rat hepatoma-derived cell lines with constructs containing the putative promoter III fused to a luc reporter. Although this promoter lacks a TATA box, a sequence close to the start site that binds the transcription factor TFIID in vitro was identified. By using PCR techniques, mRNA III (homologous to both mouse III and IV) and an mRNA (IV) with homology to VI in mouse were found in ethoxyquin- and aflatoxin B1-treated rat liver and kidney as well as in a hepatoma-derived cell line. No evidence was found for a product homologous to mRNA from promoter V described in the mouse.