Phytoplankton communities of the west coast of Florida - multiyear and seasonal responses to nutrient enrichment.

Blooms of the harmful algae species Karenia brevis are frequent off the southwest coast of Florida despite having relatively slow growth rates. The regional frequency of these harmful algal blooms led to the examination of the dominant estuarine outflows for effects on both K. brevis and the phytoplankton community in general. There is comparatively little information on the growth rates of non-Karenia taxonomic groups other than diatoms. A seasonally based series (Fall, Winter, and Spring) of bioassay experiments were conducted to determine the nutrient response of the coastal phytoplankton community. Treatments included estuarine waters (Tampa Bay, Charlotte Harbor, and the Caloosahatchee River) applied in a 1:25 dilution added to coastal water to mimic the influence of estuarine water in a coastal environment. Other treatments were 5-15 µM additions of nitrogen (N), phosphorus (P), and silica (Si) species, amino acids, and N (urea) + P added to coastal water. Incubations were conducted under ambient conditions with shading for 48 h. Analyses of dissolved and particulate nutrients were coupled with HPLC analysis of characteristic photopigments and taxonomic assignments of biomass via CHEMTAX. The coastal phytoplankton community, dominated by diatoms, cyanophytes and prasinophytes, was significantly different both by bioassay and by season, indicating little seasonal fidelity in composition. Specific growth rates of chlorophyll a indicated no significant difference between any controls, any estuarine treatment, P, or Si treatments. Conditions were uniformly N-limited with the highest growth rates in diatom biomass. Despite differing initial communities, however, there were seasonally reproducible changes in community due to the persistent growth or decline of the various taxa, including haptophytes, cyanophytes, and cryptophytes. For the one bioassay in which K. brevis was present, the slow growth of K. brevis relative to diatoms in a mixed community was evident, indicating that identifying the seasonally based behavior of other taxa in response to nutrients is critical for the simulation of phytoplankton competition and the successful prediction of the region's harmful algal blooms.

Pulse dilation gas Cherenkov detector for ultra-fast gamma reaction history at the NIF (invited).

The Cherenkov mechanism used in Gas Cherenkov Detectors (GCDs) is exceptionally fast. However, the temporal resolution of GCDs, such as the Gamma Reaction History diagnostic at the National Ignition Facility (NIF), has been limited by the current state-of-the-art photomultiplier tube technology to ∼100 ps. The soon-to-be deployed Pulse Dilation Photomultiplier Tube (PD-PMT) at NIF will allow for temporal resolution comparable to that of the gas cell or ∼10 ps. Enhanced resolution will contribute to the quest for ignition in a crucial way through precision measurements of reaction history and ablator areal density (ρR) history, leading to better constrained models. Features such as onset of alpha heating, shock reverberations, and burn truncation due to dynamically evolving failure modes may become visible for the first time. Test measurements of the PD-PMT at Atomic Weapons Establishment confirmed that design goals have been met. The PD-PMT provides dilation factors of 2 to 40× in 6 increments. The GCD-3 recently deployed at the NIF has been modified for coupling to a PD-PMT and will soon be making ultrafast measurements.

Progress on next generation gamma-ray Cherenkov detectors for the National Ignition Facility.

Fusion reaction history and ablator areal density measurements for Inertial Confinement Fusion experiments at the National Ignition Facility are currently conducted using the Gamma Reaction History diagnostic (GRH_6m). Future Gas Cherenkov Detectors (GCDs) will ultimately provide ∼100x more sensitivity, reduce the effective temporal response from ∼100 to ∼10 ps, and lower the energy threshold from 2.9 to 1.8 MeV, relative to GRH_6m. The first phase toward next generation GCDs consisted of inserting the existing coaxial GCD-3 detector into a reentrant well which puts it within 4 m of the implosion. Reaction history and ablator gamma measurement results from this Phase I are discussed here. These results demonstrate viability for the follow-on Phases of (II) the use of a revolutionary new pulse-dilation photomultiplier tube to improve the effective measurement bandwidth by >10x relative to current PMT technology; and (III) the design of a NIF-specific "Super" GCD which will be informed by the assessment of the radiation background environment within the well described here.

Clinical and cellular characterisation of Hermansky-Pudlak syndrome type 6.

BACKGROUND: In the last decade, Hermansky-Pudlak syndrome (HPS) has arisen as an instructive disorder for cell biologists to study the biogenesis of lysosome related organelles (LROs). Of the eight human HPS subtypes, only subtypes 1 through 5 are well described. AIM: To characterise extensively the HPS-6 subtype, caused by defects in HPS6, a subunit of the biogenesis of lysosome related organelles complex-2 (BLOC-2). METHODS: Mutation analysis for the HPS6 gene was performed on DNA from our group of unclassified HPS patients. The clinical phenotype of patients with HPS6 mutations was then carefully ascertained, and their cultured dermal melanocytes were employed for cellular immunofluorescence studies. RESULTS: Molecular studies showed a variety of mutations in the single exon HPS6 gene, including frame shift, missense, and nonsense mutations as well as a approximately 20 kb deletion spanning the entire HPS6 genomic region. Cellular studies revealed that the melanogenic proteins tyrosinase and tyrosinase related protein 1 failed to be efficiently delivered to the melanosomes of HPS-6 patients, explaining their hypopigmentation. Clinical studies indicated that HPS-6 patients exhibit oculocutaneous albinism and a bleeding diathesis. Importantly, granulomatous colitis and pulmonary fibrosis, debilitating features present in HPS subtypes 1 and 4, were not detected in our HPS-6 patients. CONCLUSION: The HPS-6 subtype resembles other BLOC-2 defective subtypes (that is, HPS-3 and HPS-5) in its molecular, cellular and clinical findings. These findings are not only important for providing a prognosis to newly diagnosed HPS-6 patients, but also for further elucidation of HPS function in the biogenesis of LROs.

Testing a multimedia compartmental model with monitoring data.

Based on its geographic similarity and nested structure, a chemical transport and transformation model developed in The Netherlands was adopted to a nine-parish, 5,400-km2 area in southern Louisiana, USA, and tested for its ability to predict concentrations in the environment. SimpleBox 2.0 represents a class of models that compartmentalize the air, water, soil, sediment, and plants into boxes while maintaining a high degree of detail for processes within and between boxes. Past use has been in the evaluative mode, primarily where qualitative predictions of chemical behavior and distribution are made. Limited testing of model-predicted versus measured concentrations have been attempted. In recent years, quality and quantity of emission and monitoring data have improved dramatically. Such information was used in calibration and validation exercises with eight chemicals in the Louisiana chemical corridor, which receives inputs from urban, industrial, and agricultural sources. Geographically, the corridor was nested within the state of Louisiana, which was in turn nested within the continental United States. Parameter sensitivity studies, including transport coefficients, temperature, and degradation half-life revealed that the latter produces the largest range of variation in predicted concentrations. Published half-life data were used with benzene, vinyl chloride, 1,1,1-trichloethane, and atrazine in a calibration phase with 1995 monitoring data at steady state; this allowed selection of the appropriate emission database. A validation exercise was performed with toluene, styrene, trichloroethylene, and metribuzin. Predictions were compared to average measured concentrations. Atrazine and metribuzin reside primarily in the water; the others reside in the air. The predicted concentrations for benzene, metribuzin, and trichloroethylene were low by a factor of less than two. Vinylchloride, toluene, and 1,1,1-trichloroethane were low by factors between 3 and 10. Styrene and atrazine were low by factors of 45 and 65, respectively.

Induction of a type 1 regulatory CD4 T cell response following V beta 8.2 DNA vaccination results in immune deviation and protection from experimental autoimmune encephalomyelitis.

DNA vaccination has been used to generate effective cellular as well as humoral immunity against target antigens. Here we have investigated the induction and involvement of regulatory T cell (T(reg)) responses in mediating prevention of experimental autoimmune encephalomyelitis (EAE), following vaccination with plasmid DNA encoding the TCR V(beta)8.2 chain predominantly displayed on disease-causing lymphocytes. Vaccination with DNA encoding the wild-type TCR results in priming of type 1 CD4 T(reg) and skewing of the global response to myelin basic protein in a T(h)2 direction, leading to significant protection from disease. In contrast, vaccination with mutant DNA encoding altered residues critically involved in recognition by the T(reg) results in priming of a type 2 regulatory response which fails to mediate immune deviation or protection from EAE. Control mice immunized with DNA, encoding TCR with changes at an irrelevant site, were protected from antigen-induced disease. Furthermore, protection can be transferred into naive recipients with CD4 T(reg) from wild-type DNA-immunized mice but not from animals vaccinated with the mutant DNA. These data suggest that vaccination with plasmid DNA encoding one or multiple V(beta) genes can be exploited to enhance natural regulatory responses for intervention in autoimmune conditions.

Regulation of glycogen synthase. Identification of residues involved in regulation by the allosteric ligand glucose-6-P and by phosphorylation.

The major yeast glycogen synthase, Gsy2p, is inactivated by phosphorylation and activated by the allosteric ligand glucose-6-P. From studies of recombinant proteins, the control can be accommodated by a three-state model, in which unphosphorylated enzyme has intermediate activity (state II). Glucose-6-P increased V(max)/K(m) by about 2-fold (state III), whereas phosphorylation by the cyclin-dependent protein kinase Pcl10p/Pho85p decreased V(max)/K(m) by approximately 30-fold (state I). In the presence of glucose-6-P, state III is achieved regardless of phosphorylation state. The enzyme forms complexes in solution with the yeast glycogenin Glg2p, but this interaction appears not to affect control either by glucose-6-P binding or by phosphorylation. Scanning mutagenesis was applied to identify residues potentially involved in ligand binding. Of 22 mutant enzymes analyzed, seven were essentially inactive. Five mutant proteins were altered in their activation by glucose-6-P, and two were completely unaffected by the hexose phosphate. One of these, R586A/R588A/R591A (all three of the indicated Arg residues mutated to Ala), had wild-type activity and was normally inactivated by phosphorylation. A second mutant, R579A/R580A/R582A, had somewhat reduced V(max), but its activity was not greatly reduced by phosphorylation. The Arg residues in these two mutants are restricted to a highly conserved, 13-residue segment of Gsy2p that we propose to be important for glucose-6-P binding and/or the ability of the enzyme to undergo transitions between activity states.

Mapping of atrial activation with a noncontact, multielectrode catheter in dogs.

BACKGROUND: Endocardial mapping of sustained arrhythmias has traditionally been performed with a roving diagnostic catheter. Although this approach is adequate for many tachyarrhythmias, it has limitations. The purpose of this study was to evaluate a novel noncontact mapping system for assessing atrial tachyarrhythmias. METHODS AND RESULTS: The mapping system consists of a 9F multielectrode-array balloon catheter that has 64 active electrodes and ring electrodes for emitting a locator signal. The locator signal was used to construct a 3-dimensional right atrial map; it was independently validated and was highly accurate. Virtual electrograms were calculated at 3360 endocardial sites in the right atrium. We evaluated right atrial activation by positioning the balloon catheter in the mid right atrium via a femoral venous approach. Experiments were performed on 12 normal mongrel dogs. The mean correlation coefficient between contact and virtual electrograms was 0.80+/-0.12 during sinus rhythm. Fifty episodes of atrial flutter induced in 11 animals were evaluated. In the majority of experiments, complete or almost complete reentrant circuits could be identified within the right atrium. Mean correlation coefficient between virtual and contact electrograms was 0.85+/-0.17 in atrial flutter. One hundred fifty-six episodes of pacing-induced atrial fibrillation were evaluated in 11 animals. Several distinct patterns of right atrial activation were seen, including single-activation wave fronts and multiple simultaneous-activation wave fronts. Mean correlation coefficient between virtual and contact electrograms during atrial fibrillation was 0.81+/-0.18. The accuracy of electrogram reconstruction was lower at sites >4.0 cm from the balloon center and at sites with a high spatial complexity of electrical activation. CONCLUSIONS: This novel noncontact mapping system can evaluate conduction patterns during sinus rhythm, demonstrate reentry during atrial flutter, and describe right atrial activation during atrial fibrillation. The accuracy of electrogram reconstruction was good at sites <4.0 cm from the balloon center, and thus the system has the ability to perform high-resolution multisite mapping of atrial tachyarrhythmias in vivo.

Validation of a new noncontact catheter system for electroanatomic mapping of left ventricular endocardium.

BACKGROUND: Improvements in cardiac mapping are required to advance our understanding and treatment of arrhythmias. This study validated a new noncontact multielectrode array catheter and accompanying analysis system to provide electroanatomic mapping of the entire left ventricular (LV) endocardium during a single beat. METHODS AND RESULTS: A 9F 64-electrode balloon array catheter with an inflated size of 1.8x4.6 cm was used to simultaneously record electrical potentials generated by the heart and locate a standard electrophysiology (EP) catheter within the same chamber. By use of the recorded location of the EP-catheter tip, LV geometry was determined. Array potentials served as inputs to a high-order boundary-element method to produce 3360 potential points on the endocardial surface translatable into electrograms or color-coded activation maps. Three methods of validation were used: (1) driven electrodes in an in vitro tank were located; (2) waveforms generated from the array catheter were compared with catheter contact waveforms in canine LV; and (3) sites of local LV endocardial activation were located and marked with radiofrequency lesions. Tank testing located a driven electrode to within 2.33+/-0.44 mm. Correlation of timing and morphology of computed versus contact electrograms was 0.966. Radiofrequency lesions marked 17 endocardial pacing sites to within 4.0+/-3.2 mm. CONCLUSIONS: This new system provides anatomically accurate endocardial isopotential mapping during a single cardiac cycle. The locator component enabled placement of a separate EP catheter to any site within the mapped chamber.

Histone II-A activates the glucose-6-phosphatase system without microsomal membrane permeabilization.

Many agents have been used to release the latent portion of the activities catalyzed by the glucose-6-phosphatase (Glc-6-Pase) system. Detergents, which disrupt the microsomal membrane concomitantly with Glc-6-Pase activation, have been the most widely used of these agents. The treatment of microsomes with alamethicin or histone II-A has also been reported to activate the Glc-6-Pase system to the same extent as detergent treatment. While alamethicin reportedly permeabilizes the microsomal membrane (R. Fulceri et al., 1995, Biochem. J. 307, 391-397), conflicting ideas as to histone II-A's mechanism of activation have been described (J. St.-Denis et al., 1995, Biochem. J. 310, 221-224 and J. Blair and A. Burchell, 1988, Biochim. Biophys. Acta 964, 161-167). We further investigated whether activation of the Glc-6-Pase system by histone II-A is due to permeabilization of the microsomal membrane. We treated rat liver microsomes with Triton X-100, alamethicin, or histone II-A and found them to be equally effective in maximally activating the Glc-6-Pase system. We also examined the modifying effects of alamethicin and histone II-A on the sensitivity of Glc-6-Pase activities to inhibition by N-bromoacetylethanolamine phosphate (BAEP) and 3-mercaptopicolinate (3-MP), both thiol-directed reagents. Alamethicin, but not histone II-A, abolished the inhibitory effects of BAEP and 3-MP on activities of the Glc-6-Pase system. Our studies support previous reports of Glc-6-Pase activation by alamethicin via permeabilization of microsomal membranes and histone II-A activation without microsomal membrane permeabilization.

Low-Km mannose-6-phosphatase as a criterion for microsomal integrity.

The low-Km activity of mannose-6-phosphatase (Man-6-Pase) has been used for many years to measure the structural integrity of microsomes. Recently histone II-A has been shown to activate glucose-6-phosphatase (Glc-6-Pase) and Man-6-Pase activities. However, in contrast to detergents, this compound appears to activate without disrupting microsomal vesicles (J.-F. St-Denis, B. Annabi, H. Khoury, and G. van de Werve. 1995. Biochem. J. 310: 221-224). This suggests that Man-6-Pase latency can be abolished without disrupting microsomal integrity and that even normally microsomes may manifest some low-Km Man-6-Pase activity without being "leaky." We have studied the relationship of Man-6-Pase with microsomal integrity further by measuring the latency of several enzymes reported to reside within the lumen of endoplasmic reticulum. We have also correlated this latency with the microsomal permeability of substrates for these enzymes. We found that (i) lumenal enzymes have different degrees of latency when compared with each other, (ii) permeability, as determined via osmotically induced changes in light scattering, is not always consistent with enzymatic latency, (iii) increases in the hydrolysis of Glc-6-P and Man-6-P were not parallel when microsomes were treated with low but increasing concentrations of detergent, and (iv) kinetic studies suggest that mannose-6-phosphate is hydrolyzed by untreated microsomes by more than a single mechanism. We propose that Man-6-Pase is not a reliable index of the integrity of microsomes.

Effects of ionic strength and chloride ion on activities of the glucose-6-phosphatase system: regulation of the biosynthetic activity of glucose-6-phosphatase by chloride ion inhibition/deinhibition.

Certain amino acids stimulate glycogenesis from glucose. The regulatory volume decrease mechanism explaining these effects was defined by Meijer et al. (1992, J. Biol. Chem. 267, 5823-5828). It involves amino acid-induced swelling of hepatocytes resulting in loss of chloride ions which leads to deinhibition of glycogen synthase phosphatase. This results in enhanced conversion of the inactive to active form of glycogen synthase and thus enhanced glycogen synthesis. We have studied the effects of amino acids and chloride ion on the glucose-6-phosphatase system (Glc-6-Pase) with rat liver microsomal preparations, and correlated our results with those reported by others with glycogen synthase. Glc-6-Pase activities are increased by elevated ionic strength varied by increasing the concentration of various buffers or charged amino acids but are not affected by changes in osmolarity, varied with disaccharides or uncharged amino acids. With undisrupted microsomes, chloride ion competitively inhibits carbamyl phosphate: glucose phosphotransferase (KCP,t,UMi,Cl- = 19 mM) more extensively than Glc-6-P phosphohydrolase (KG6P,h,UMi,Cl- = 117 mM). Inhibition by chloride ion and activation due to ionic strength may be important considerations when assessing in vitro Glc-6-Pase activities where an attempt is made to replicate physiologic conditions. Further we propose that amino acids may play a role in increasing biosynthetic activity of Glc-6-Pase, as well as previously characterized glycogen synthase (Meijer et al., op. cit.), via the regulatory volume decrease mechanism through diminished chloride ion inhibition. Reduced concentration of chloride ion will (1) deinhibit the biosynthetic activity of Glc-6-Pase, while still inhibiting Glc-6-P hydrolysis, leading to an increased cellular concentration of Glc-6-P (an important glycogenic intermediate as well as allosteric activator of glycogen synthase) and (2) increase the active form of glycogen synthase by deinhibiting glycogen synthase phosphatase both through the previously defined mechanism (see above) and via Glc-6-P-enhanced conversion of glycogen synthase from its inactive to active form. We propose that the biosynthetic activity of Glc-6-Pase may act in concert with glycogen synthase during amino acid-induced glycogenesis from glucose.

Glucose-6-phosphatase structure, regulation, and function: an update.

Work on the glucose-6-phosphatase system has intensified and diversified extensively in the past 3 years. The gene for the catalytic unit of the liver enzyme has been cloned from three species, and regulation at the level of gene expression is being studied in several laboratories worldwide. More than 20 sites of mutation in the catalytic unit protein have been demonstrated to underlie glycogenesis type 1a. inhibition of glucose-6-P hydrolysis by several newly identified competitive and time-dependent, irreversible inhibitors has been demonstrated and in several instances the predicted effects on liver glycogen formation and/or breakdown and on blood glucose production have been shown. Refinements in and additions to the presently dominant "substrate transport-catalytic unit" topological model for the glucose-6-phosphatase system have been made. A new model alternative to this, based on the "combined conformational flexibility-substrate transport" concept, has emerged. Experimental evidence for the phosphorylation of glucose in liver by high-K(m),glucose enzyme(s) in addition to glucokinase has continued to emerge, and new in vitro evidence supportive of biosynthetic functions of the glucose-6-phosphatase system in this role has appeared. High levels of multifunctional glucose-6-phosphatase have been shown present in pancreatic islet beta cells. Glucose-6-P has been established as the likely insulin secretagog in beta cells. Interesting differences in the temporal responses of glucose-6-phosphatase in kidney and liver have been demonstrated. An initial attempt is made here to meld the hepatic and pancreatic islet beta-cell glucose-6-phosphatase systems, and to a lesser extent the kidney tubular and small intestinal mucosal glucose-6-phosphatase systems into an integrated, coordinated mechanism involved in whole-body glucose homeostasis in health and disease.

Inhibition of the glucose-6-phosphatase system by N-bromoacetylethanolamine phosphate, a potential affinity label for auxiliary proteins.

N-Bromoacetylethanolamine phosphate (BAEP) has been used previously as an affinity label to study the hexose phosphate binding sites of fructose-6-P, 2-kinase:fructose-2, 6-bisphosphatase (Sakakibara et al. (1984) J. Biol. Chem. 259, 14023-14028). We have employed this compound to probe components of the glucose-6-phosphatase system using a combination of time-dependent and immediate inhibition kinetic techniques. Inhibition of D-glucose-6-phosphate (G6P) phosphohydrolase activity of native microsomes was irreversible and time- and inhibitor-concentration-dependent. Only a partial time-dependent, irreversible inhibition of the PPi phosphohydrolase activity of native microsomes was observed. BAEP inhibited PPi:glucose phosphotransferase activity of native microsomes in a concentration-dependent, irreversible manner which was more extensive than that seen with PPi phosphohydrolase, but less extensive than was observed with G6P phosphohydrolase. Disruption of microsomal integrity by detergent-treatment either prior to incubation with BAEP or subsequent to preliminary incubation with BAEP but prior to assay for activity abolished the time-dependent inhibition. These irreversible, time- and concentration-dependent inhibitory actions of BAEP thus are manifest at a site or sites where the intact membrane-bound enzyme first makes contact with substrates G6P and PPi. An additional site of inhibition by BAEP, through relatively weak, reversible competitive inhibition at the active catalytic site, is indicated by classical steady-state kinetic analysis. The irreversible, time- and concentration-dependent inhibitions by BAEP seen with G6P and PPi as substrates strongly suggest the potential utility of radio-labeled BAEP as an affinity label for the identification and ultimate isolation and study of uncharacterized auxiliary components of the glucose-6-phosphatase system.

Comparison of the mechanical and histologic properties of Achilles tendons in New Zealand white rabbits secondarily repaired with Marlex mesh.

Over the years, there have been numberous reports on the treatment of tendo Achillis ruptures. Most of these dissertations have dealt with the treatment of acute ruptures versus the more technically challenging, neglected, ancient rupture. This paper will focus on the neglected rupture, with specific attention directed towards a new technique of surgical repair, using Marlex mesh. Through the exhaustive testing of the tendo Achillis of New Zealand white rabbits at intervals of 1, 3, and 6 months postimplantation, and subsequent implantation in a 13-month follow-up in an adult, it has been demonstrated that this biosynthetic tendon complex very closely approximates the physical properties of the normal tendo Achillis. Furthermore, through the use of histologic examination, it has been shown that this material actually forms a frame or bridgework for ingrowth of normal, orderly, collagen bundles, closely resembling those found in the original tendinous structure.

Mitek Anchor System: a new technique for tenodesis and ligamentous repair of the foot and ankle.

The authors present an alternative method for securing tendon and ligaments to bone, utilizing the Mitek Anchor System. The description of the Mitek system and technique of application is presented. Technical simplicity and ease of adaptability within the foot and ankle are distinct advantages of this System.

The feasibility of utilizing the systolic pre-ejection interval as a determinant of pacing rate.

Rate-modulated pacing modes adjust the stimulus rate by responding to sensed alterations in physiologic indexes of metabolic demand. This study was designed to determine whether right ventricular pre-ejection interval, measured in patients by a prototype pacemaker system capable of tracking intraventricular volume, changes predictably with exercise and, if so, whether it can be used in an algorithm to vary heart rate appropriately. This system utilizes intraventricular electrical impedance measurements of injected microampere currents to determine intracavitary volume changes. Five pacemaker-dependent patients underwent temporary insertion of a tripolar electrode connected to an external device that sensed cardiac signals, generated an impedance wave form and produced stimuli at rates dependent on pre-ejection interval. Pre-ejection interval did not change as a result of variations in pacing rate itself (347 +/- 41 ms at 70 beats/min versus 321 +/- 19 ms at 130 beats/min), but consistently decreased during graded exercise (by 23% from baseline). During rate-modulated pacing based on pre-ejection interval, heart rate significantly increased during exercise compared with ventricular demand pacing (by 46 +/- 6 versus 7 +/- 6 beats/min, respectively), and increased appropriately during burst exercise. Thus, the pre-ejection interval appears to be a specific, reliable physiologic determinant of pacing rate during exertion, which may be applicable in implantable rate-modulated pacemakers.

The efficacy of 5-fluorouracil, mitomycin C, and methyl CCNU in advanced colorectal cancer.

Sixty-six patients with advanced colorectal cancer were treated with 5-fluorouracil, Mitomycin C, and 1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea. Fifty-seven patients were evaluable by completing 2 months of therapy. Nine patients (16.0%) achieved a complete remission (CR) with the above combination. A partial remission (PR) was seen in 9 patients. The response rate (CR + PR) was 32%. The average duration of response was 8.5 months. Mucositis, leukopenia, and thrombocytopenia were the significant toxicities experienced in this study.

Continuous ventricular volume assessment for diagnosis and pacemaker control.

Stroke volume measurements made by a catheter-based, right ventricular, intracardiac impedance system at rest and during upright bicycle ergometry were found to compare favorably with measurements made by acetylene rebreathing (r = 0.96, n = 13) and by radionuclide ventriculography (r = 0.96, n = 13) in a 46-year-old male pacemaker-dependent subject. The impedance information was then used to control the ventricular pacing rate during bicycle exercise, utilizing an algorithm that attempts to maintain a constant stroke volume. This resulted in a 23% increase in cardiac output accompanied by a 70% decrease in stroke volume as compared to the values measured during the same exercise at 70 pulses per minute (ppm).