A 13C-NMR study of the biosynthesis of 3-methylpentacosane in the American cockroach.

13C-NMR spectrometry was used to examine the in vivo incorporation of 13C-labeled precursors into 3-methylpentacosane in the cockroach Periplaneta americana. Natural abundance 13C-NMR of 3-methylpentacosane showed that carbons 1 through 6, 23 through 25 and the branching methyl carbon (C26) each gave distinct signals, with carbons 7 through 22 indistinguishable from each other. The label from dipotassium 2-[methyl-13C]methylmalonate was incorporated primarily into the methyl branch of 3-methylpentacosane, demonstrating the 2-methylmalonate is the precursor to the methyl branch unit. The carboxyl carbon from sodium [1-13C]propionate was incorporated exclusively into the 4-position. This indicates that propionate, as a 2-methylmalonyl derivative, is incorporated as the second unit during chain synthesis rather than toward the end of the elongation process. The labeled carbon from sodium [1-13C]acetate was incorporated into carbons 2, 6 and 24 and the labeled carbon from [2-13C]acetate was incorporated into carbons 1, 5, 23 and 25 of 3-methylpentacosane, respectively. These data are consistent with an elongation-decarboxylation pathway for 3-methylpentacosane biosynthesis.

Sarcomas of the uterine corpus: prognostic factors and treatment.

Twenty-eight patients with sarcomas of the uterine corpus were followed at least 22 months or until death. All underwent laparotomy, eleven had radiation therapy, and six had chemotherapy. Three year actuarial survival was 24%, and three year actuarial local control was 36%. Multivariate analysis demonstrated that, as with sarcomas at other sites, the most important factors influencing survival were grade (P = 0.020) and stage (P = 0.022). For local control, multivariate analysis indicated the most important factors to be stage (P = 0.001) and radiation TDF (P = 0.01). Of 21 failures, 16 involved the pelvis, seven involved the upper abdomen, and 11 involved distant sites. The importance of both local and distant disease control is emphasized.

Electrochemistry of flavonoids. Relationships between redox potentials, inhibition of mitochondrial respiration, and production of oxygen radicals by flavonoids.

We have investigated the redox behavior of a series of structurally related flavonoids employing cyclic voltammetry under physiological conditions. The flavonoids that auto-oxidized and produced oxygen radicals had oxidation potentials (E 1/2) significantly lower [-30 to +60 mV vs (SCE)] than those that did not undergo auto-oxidation (+130 to +340 mV vs SCE). The range of E 1/2 values for the auto-oxidizable flavonoids was comparable to the E 1/2 range reported for the optimum quinone induced production of superoxide (O2 pi) in mitochondrial NADH-CoQ reductase (complex I). The most potent flavonoid inhibitors of mitochondrial succinate-CoQ reductase (complex II) possessed hydroxyl configurations capable of supporting redox reactions. For a series of 3,5,7-trihydroxyflavones that differed by b-ring hydroxylation it was found that decreasing E 1/2 of the flavonoids was associated with decreasing I50 values towards succinoxidase. These findings suggest that the electrochemical properties of the flavonoids may contribute to their biological activity.

Treatment of urinary incontinence after radical hysterectomy.

The results of therapy of eight previously untreated women without urinary fistulas who had been severely incontinent for three to eight years after radical hysterectomy are presented and the principles of management discussed. Radiologic and urodynamic studies are required to assess the bladder pressure response to filling, proximal urethral pressures, bladder neck closure at rest, and mobility of the bladder neck, to determine the mechanism responsible for the urine loss and to select appropriate therapy. Augmentation of proximal urethral pressures by medical or surgical means is required if the bladder neck is open at rest. All such patients improved dramatically on ephedrine, but tachyphylaxis developed in cases of total sphincter failure. Retropubic urethropexy did not relieve the incontinence in these cases, whereas a sling operation restored complete continence. If an incremental bladder pressure response to filling is present, operations to increase bladder outlet resistance are contraindicated. Treatment with anticholinergic medications was unsuccessful in these cases.

Sling operation for total incontinence following radical vulvectomy.

A case of total incontinence that developed after radical vulvectomy and subtotal urethrectomy is presented. Complete relief of the incontinence was obtained after an Aldridge sling operation. The rationale for selecting this operation is discussed.

Oral calcium tolerance and urinary cyclic AMP in urolithiasis.

Oral calcium tolerance and urinary cyclic AMP testing was used in the evaluation of 61 unselected patients with stones. The oral calcium tolerance test was easy to perform and was useful in defining several distinct metabolic abnormalities contributing to calculous formation. Oral calcium tolerance testing is more precise than twenty-four-hour urinary calcium determination and should provide a means of determining proper medical treatment of urolithiasis. Urinary cyclic AMP was disappointing as a measure of parathormone activity.

ESWL treatment of urinary calculi.

A total of 711 patients with symptomatic upper and lower urinary tract calculi underwent extracorporeal shock-wave lithotripsy (ESWL) at the Ohio Kidney Stone Center during the first six months. At follow-up 84 percent of the first 180 patients are stone-free. Retreatment was required for 2.8 percent of the patients with residual stone material. Thirty-seven percent of the treatments required cystoscopy with ureteral stent placement for manipulation of stones or delineation of distal ureteral anatomy to facilitate ESWL. Complications were minimal at less than 3 percent.

Comparing the medical school curricula followed by students in an independent study program and a traditional one.

This 1988 retrospective study examined the medical school curricula followed by students from two classes using two curricular styles at one medical school. By consulting school records, the authors ascertained the courses actually taken, the number of weeks that students actually devoted to them, and the sequence of courses, both for those students following an independent-study curriculum and for those following a traditional one. These data were compared with the corresponding data concerning the traditional curriculum requirements to determine whether the curricula the students actually followed, in either style, showed any marked difference from the required curriculum. The findings showed that the curricula followed by the independent-study students deviated considerably from both the requirements of the traditional curriculum and also the actual curricula followed by the students using the traditional curriculum, who almost never chose to deviate from the requirements. The independent-study students showed considerable intragroup variation in the ways they organized their curricula, most commonly in eliminating selected formal clerkship or specialty medicine courses, or altering the duration of clerkships. Elective coursework was substituted for formal clerkship experiences in the majority of cases where clerkship courses were eliminated.

Bleeding patterns with low-dose, monophasic oral contraceptives.

Cycle control over 12 months with low-dose oral contraceptives (OCs) was analyzed using calendars of bleeding on pill-taking days 1 through 21 (intermenstrual bleeding; IMB). One preparation contained 0.5 mg norethindrone and 0.035 mg ethinyl estradiol (NET + EE), the other 0.3 mg norgestrel and 0.03 mg ethinyl estradiol (Ng + EE). Half the subjects had previously used OCs containing greater than or equal to 0.05 mg estrogen (switch-over); the others had not previously used OCs for 2 months or more (fresh). Fresh subjects reported more IMB than switch-over subjects, especially during the first three cycles; IMB decreased over time for both groups. Ng + EE subjects had fewer IMB episodes during the early cycles than NET + EE subjects. Daily incidence of IMB formed a characteristic W-shaped curve in the NET + EE subjects that was most apparent in early cycles.

Indirect determination of tetrahydroborate (BH(-)(4)) by gas-diffusion flow injection analysis with amperometric detection.

A rapid, indirect gas-diffusion flow injection analysis (FIA) method with amperometric detection has been developed for the selective and sensitive determination of tetrahydroborate (BH(-)(4)). The injected analyte reduces arsenic(III) to arsine. The arsine formed diffuses through the PTFE (polytetrafluoroethylene) membrane and is quantified amperometrically at a platinum working electrode. The precision of the technique was better than a relative standard deviation of 2.1% at 60 muM levels and better than 0.5% at 0.1 mM, with a throughput of 60 samples/hr. The detection limit of the method was found to be 1 muM (1.5 ng BH(-)(4)) with a linear range up to 1 mM. The dynamic range extends over five orders of magnitude in BH(-)(4) concentration. The effects of working potential, concentration of As(III) and HCl in the reagent stream, type and flow rate of the acceptor solution, temperature and interferents on the FIA signals were studied.

Photocatalytic detoxification of cyanide and metal cyano-species from precious-metal mill effluents.

Photochemically-induced detoxification of various cyanide species from a selected precious-metal mills tailings was investigated in detail. The studies were conducted in the presence or absence of a titanium (IV) oxide semiconductor photocatalyst utilizing simulated sunlight as the irradiation source. It was established that the cyanide ion (both free and complexed) was photocatalytically oxidized to nitrate via cyanate and nitrite. In addition iron, copper, zinc, mercury and arsenic were stabilized as precipitates. The results obtained may have ramifications for the possible use of solar energy for the efficient treatment of large quantities of precious-metal mill-tailing wastes that contain various cyano-species.

Evaluation of a carbamate-impregnated flea and tick collar for dogs.

To acquire information regarding the potential hazard of pesticide-impregnated collars to dogs, 13 male Beagles were allotted to 2 groups; 8 of the dogs were fitted wtih propoxur-impregnated tick and flea collars and the other 5 were fitted with placebo collars. All dogs wore their collars for 42 consecutive days. The dogs wearing test collars had significant (P less than 0.01) depression of erythrocyte and plasma cholinesterase activities at day 1 after collar application; however, the enzyme activity values returned to the preexposure range within 3 days. Miosis, with decreased pupillary response, was noticed during the 1st week of exposure. Irritation of the skin of the neck was mild and transient in both the test and control groups from the 2nd week onward.

Extracorporeal shock wave lithotripsy (ESWL).

There hundred sixteen patients with symptomatic upper and lower urinary tract calculi underwent extracorporeal shock wave lithotripsy (ESWL) at the Ohio Kidney Stone Center during the first three months. Ninety-seven percent of the stones were treated with one ESWL session. Twenty-four percent of the treatments required cystoscopy with ureteral stent placement for manipulation of stones to facilitate ESWL. Complications were minimal, less than three percent.

Pulsed, non-thermal, high-frequency electromagnetic energy (DIAPULSE) in the treatment of grade I and grade II ankle sprains.

Acutely sprained ankles represent a frequent and common injury among active duty troops in training, and are a significant source of morbidity with respect to days lost to training. Swelling in the form of periarticular edema limits motion, causes pain, prevents wearing of normal foot gear, and slows the healing process. Reduction of edema was attempted in acutely sprained ankles by the use of pulsed electromagnetic energy (Diapulse). In a randomized, prospective, double blind study of 50 grade I and II (no gross instability) sprained ankles, a statistically significant (p < 0.01) decrease in edema was noted following one treatment with Diapulse. The application of this modality in acutely sprained ankles could result in significant decreases in time lost to military training.

Health promotion for children. Key to a lifetime of health.

Evidence indicates that preventive healthcare in childhood reduces healthcare costs and enhances health. Physicians can assume a leadership role in promoting children's health by incorporating health promotion measures into their everyday practice, serving as resource persons or leaders in community and school efforts in health promotion, and lobbying for legislation aimed at preventive care. The goals of these efforts are to achieve a healthy childhood, provide a foundation for a healthy adulthood, and develop in children positive values about personal health responsibility and use of healthcare services.

Intraperitoneal cisplatin-based chemotherapy for primary treatment of epithelial ovarian cancer.

INTRODUCTION: This study looks at the feasibility of intraperitoneal cisplatin-based treatment in patients newly diagnosed with ovarian cancer in a community hospital setting and provides long-term follow-up of a cohort of patients. METHODS: Sixteen patients with epithelial ovarian cancer were studied. All patients underwent definitive surgical debulking. Patients were scheduled to be treated with six cycles of intraperitoneal cisplatin and either intravenous cyclophosphamide or intravenous doxorubicin at four week intervals. RESULTS: Fifteen patients were evaluable for response. All patients received at least three cycles of intraperitoneal therapy. All patients had an initial clinical response. Nine of 15 patients underwent second-look laparotomy; five of the nine patients had positive second-looks, none had residual macroscopic disease. Of the remaining six patients, five had clinical complete remissions and four are alive without recurrence. CONCLUSION: High-dose intraperitoneal cisplatin-based with sodium thiosulfate protection is generally well-tolerated and possibly an appropriate alternative first-line therapy for selected patients with epithelial ovarian cancer.

Evaluation of closed container flash sterilization system.

Flash sterilization is a rapid, effective procedure for providing sterile instruments for surgery; however, aseptic transport of an unwrapped sterile tray is a major problem. This study tested the effectiveness of using a closed container for flash sterilization, and found the closed container to be an effective alternative to the traditional open tray for flash sterilization and transportation of sterile supplies.