Evolution of viviparity in horned lizards (Phrynosoma): testing the cold-climate hypothesis.

The cold-climate hypothesis for evolution of viviparity in squamates predicts a correlation between reproductive mode, altitude and latitude. I tested this prediction in horned lizards within a phylogenetic context. I first determined whether all viviparous species were monophyletic using Monte Carlo simulations. Secondly, I tested for presence of phylogenetic signal using randomization tests. Thirdly, I analysed relationships between reproductive mode and minimum, midpoint, and maximum altitudes and latitudes by computing conventional correlations and phylogenetically independent contrasts. Viviparous species do not form a monophyletic group suggesting viviparity evolved twice in the genus. Viviparity and altitude showed strong phylogenetic signal based on randomization tests and were significantly correlated, while latitude was not correlated with reproductive mode. This study partially supports the cold-climate model, but also suggests that altitude either may be a better predictor of cold temperatures or may be a surrogate for other selective factors important in the evolution of viviparity.

In-line leukocyte filtration during bypass. Clinical results from a randomized prospective trial.

Leukocyte mediated pulmonary injury may delay recovery after cardiac surgery, and leukocyte depletion during bypass has been suggested. Two groups of patients were randomly, prospectively assigned from 50 sequential patients to undergo open heart surgery using cardiopulmonary bypass, either with (n = 25) or without (n = 25) leukocyte filters. The two groups were not significantly different regarding age, gender, race, pre-operative ejection fraction, pump time, or cross-clamp time. Post operative arterial blood gases (pO2: 173 +/- 66 vs 192 +/- 107; pCO2: 30.2 +/- 8.2 vs 30.8 +/- 8.0), pulmonary vascular resistance (PVR 105 +/- 45 vs 112 +/- 50 dyne cm-5), time on ventilator (17.8 +/- 6.4 vs 19.7 +/- 8.6 hr), and length of hospital stay (7.65 +/- 4.57 vs 8.52 +/- 5.87 days) were not different between groups (mean +/- SD, with vs without filters, respectively). Arterial oxygenation was somewhat poorer, and PVR was somewhat lower in the leukocyte filtered group. However, these trends did not produce significant decreases in total ventilator time or length of hospital stay. In-line filtration did remove leukocytes, but did not reduce circulating leukocyte count. In effect, leukocyte filtration produced an effective leukocyte concentration at the filter site. These data do not support routine incorporation of in-line leukocyte filtration during bypass.

Cervical and vaginal cytologic smears suggestive of adenocarcinoma.

OBJECTIVE: To determine the appropriate evaluation of women with cervical cytologic smears suggestive of adenocareinoma. STUDY DESIGN: Of 1,192,972 smears obtained between July 1989 and March 1992, 57 (0.005%) were interpreted as adenocarcinoma, adenocarcinoma in situ or "rule out" adenocarcinoma. Review of medical records allowed the determination of pathologic diagnoses in 46 of 57 women. Thirty of the 46 cytologic smears were reviewed. RESULTS: Fifteen of the 46 women were premenopausal and < 50 years of age. Twenty-three were asymptomatic, 22 had abnormal vaginal bleeding, and 1 had increasing abdominal girth. Twenty-nine (63%) of the 46 women had cancer, 12 (26%) had cervical intraepithelial neoplasia 2 (CIN 2) or 3, and 5 (11%) had CIN 1, condyloma or no pathology. Of the 29 women with cancer, 11 had cervical cancer, 1 had vaginal cancer, 13 had uterine cancer, and 4 had extrauterine cancer. Nineteen of 22 women (86%) with abnormal vaginal bleeding had cancer; 9 of 23 asymptomatic women had cancer (39%) (chi 2 = 9.84, P < .01). DISCUSSION: Women with smears suggestive of adenocarcinoma require biopsy of cervical or vaginal masses, colposcopy with directed biopsy, endocervical curettage and endometrial biopsy. If cancer is not diagnosed, cervical conization with dilatation and curettage (D&C) is indicated. If conization with D&C is negative, laparoscopy is indicated to exclude extrauterine cancer.

Eosinophilic gastroenteritis.

Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptomatology. Eosinophilic gastroenteritis is generally classified according to the layer of gastrointestinal tract involved. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Patients with mild and sporadic symptoms can be managed with reassurance and expectant observation. Patients with disabling symptoms can be effectively treated with corticosteroids after other systemic disorders associated with peripheral eosinophilia have been excluded. Occasionally, sodium cromolyn, ketotifen, and/or elimination diets have been shown to be effective in the management of patients who have a significant history of allergic disorder. Surgical intervention may be required in patients with obstructive complications or refractory disease.

Antibody to HIV-1, HTLV-I, and HCV in three populations of rural Haitians.

The seroprevalence of antibodies to HIV-1, HTLV-I, and HCV was evaluated in three populations from northern rural Haiti: 1,727 patients attending the hospital for symptoms suggestive of HIV disease, 228 consecutive surgical patients, and 500 pregnant women were tested. HIV-1 seroprevalence was 6.1 and 4.0% in the last two groups, respectively, and 39.3% in the symptomatic population. Associated symptoms of wasting, cough, and diarrhea and a clinical diagnosis of AIDS were significantly predictive of HIV-1 seropositivity. Antibody to HTLV-I seroprevalence ranged from 2.2-5.3% in pregnant women, surgical patients, and HIV-seronegative symptomatic patients and was similar among the three groups when stratified by age. In contrast, HIV-1 seropositivity and HTLV-I seropositivity were significantly associated. The prevalence of confirmed antibody to HCV was low and not associated with either HIV-1 or HTLV-I seropositivity.

Surgical management of renal cell carcinoma with extensive intracaval involvement using a venous bypass system suitable for rapid conversion to total cardiopulmonary bypass.

Renal cell carcinoma involves the vena cava in approximately 4% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Recently management of extensive vena caval involvement has involved the use of cardiopulmonary bypass with circulatory arrest and hypothermia. We describe a technique using a venous bypass pump system (femoral vein to right atrium) for resection of renal cell carcinoma with suprahepatic vena caval extension (type II), which avoids the risks and complications of cardiac arrest and hypothermia but allows for rapid conversion to total cardiopulmonary bypass should the intraoperative need arise.

Protection against streptococcal pharyngeal colonization with a vaccinia: M protein recombinant.

Phagocytosis of group A streptococci requires type-specific antibodies directed against the variable determinants of the bacterial surface M protein molecule. As a step toward developing a broadly protective anti-streptococcal vaccine, a vaccinia virus (VV) recombinant was constructed that expresses the conserved region of the structural gene encoding the M6 molecule (VV:M6'). Mice immunized intranasally with the VV:M6' virus showed markedly reduced pharyngeal colonization by streptococci after intranasal and oral challenge with these bacteria. M protein-specific serum immunoglobulin G was significantly elevated in vaccinated animals and absent in controls. A similar approach may prove useful for the identification of protective determinants present on other bacterial and viral pathogens.

Expression of streptococcal M protein in mammalian cells.

The M protein encoded by group A streptococci is a cell-wall polypeptide that has the property of enabling these organisms to evade the phagocytic cells of the human host. Therefore, the M protein plays a major role in the pathogenesis of streptococcal diseases. As an initial step toward the use of this protein as a target antigen for the production of protective anti-streptococcal immunity, a live vaccinia virus recombinant containing the M-protein gene has been constructed (VV:M6 delta). The bacterial M-protein DNA sequence is stable within this genetic context and is actively transcribed by viral RNA polymerase. Furthermore, high levels of immunoreactive M protein were detected in vivo when the VV:M6 delta recombinant was used to infect mammalian cells in culture. Thus, in addition to providing a powerful approach for dissecting the immunodominant domains of the M protein, the VV:M6 delta recombinant appears to be an excellent candidate vaccine for animal trials.

Cell-free translation of a chimeric eucaryotic-procaryotic message yields functional chloramphenicol acetyltransferase.

A vaccinia virus (VV) recombinant containing the DNA sequences encoding the bacterial chloramphenicol acetyltransferase (CAT) gene was constructed. The ability of the chimeric VV:CAT transcript to be translated in vitro into enzymatically active enzyme was assessed. Addition of mRNA isolated from the cytoplasm of VV:CAT infected cells to a mRNA-dependent reticulocyte lysate resulted in the synthesis of high levels of enzymatically active CAT. These results suggest that this assay may be used in concert with physical assays to study the expression and stability of chimeric transcripts in virus-infected cells.

Construction of recombinant vaccinia virus strains using single-stranded DNA insertion vectors.

The ability of single-stranded (ss) DNA, isolated from recombinant M13 bacteriophage, to direct the insertion of foreign genetic elements into the vaccinia virus (VV) genome was examined. An identical chimeric transcriptional unit [VV promoter/chloramphenicol acetyl transferase (CAT) gene embedded in DNA sequences encoding vaccinia virus thymidine kinase (TK)] was inserted into either the previously characterized plasmid insertion vector, pGS20, or into M13mp18. It was found that the ss vector (M13mp18:TK/CAT) was four times more efficient than the plasmid vector (pGS20:CAT) in catalyzing homologous recombination of the cat gene by marker transfer into the VV genome. Furthermore, Southern blot analyses and CAT enzymatic activity assays confirmed that the structure of the M13-derived recombinant genomes were as expected and that the chimeric genes were fully active. Although the precise mechanism responsible for the ss DNA-catalyzed insertion event is not known, these results are discussed with respect to the advantages of using M13-based vectors with which to manipulate and insert genetic information into infectious VV recombinants.

Parasitological, serological, and clinical studies of Wuchereria bancrofti in Limbe, Haiti.

A survey for Wuchereria bancrofti in Limbe, Haiti (est. pop. = 10,500) revealed that 17% (231/1,450) had a patent infection. Nearly half of those surveyed harbored fewer than 10 microfilariae (mf) per 20 mm3 of finger-prick blood; the median mf density for females and males was 12.4 and 9.5, respectively. Parasitemias occurred as early as age 4. Antibody titers greater than or equal to 1:20 against adult D. viteae antigen were observed in 38% of microfilaremic individuals and in 29% of amicrofilaremic individuals. Peak antibody responsiveness (40%) was observed between 5 and 9 years of age. In all age groups there was no correlation between mf density and antibody titer. Among the mf carriers, 5.6% had no clinical symptoms. Lymphangitis was a common feature with 14.3% having lymphedema, 8.2% with edema of the lower extremities, and 1.3% reporting episodes of chyluria. Genital involvement among women was rare, but in males 5.4% had genital swelling and 4.5% had hydroceles. Culex pipiens quinquefasciatus (Say) was observed to support the complete development of W. bancrofti in Limbe.

[Lymphatic filariasis in Haiti. Results of treatment with diethylcarbamazine in the town of Limbe]. / Filariose lymphatique en Haiti. Résultats du traitement par le diéthylcarbamazine dans la ville du Limbe.

In the town of Limbe, in Haiti, 16,8% of the inhabitants show W. bancrofti microfilariae in their blood taken by finger prick between 8.00 and 10.00 p.m. From those positive patients, 208 have received a cure of DEC at the dosage of 6 mg/kg/day during ten days. The control of the therapeutic efficacity among 190 patients, after three and a half months of this cure, shows a negativity of 72%. The positives patients show a very low parasitic charge (MfD50 = 1.9). If the secondary effects are frequent (83.7%), they are often benign and temporary.

A preventive program for the newly separated: initial evaluation.

A 6-month long preventive intervention program for newly separated persons was designed on the basis of an analysis of the literature that identified the major stressful elements in the separation experience. Following the implementation of the program, its impact was assessed by contrasting persons who were assigned to the program (n = 100) with newly separated persons who were randomly selected to serve as a no-treatment control group (n = 50). Of the nine dependent measures of adjustment used in this evaluation, five significant posttreatment differences were found, in each case favoring the intervention group. The nature of these significant differences is particularly encouraging in light of the preventively oriented objectives of the intervention program. Detailed analysis of program characteristics resulted in the identification of desirable program modifications that could be implemented when the program is reinstituted.

The predicament of the newly separated.

This study examines early adjustment to marital separation as a function of sex and parent status in a sample of 153 persons separated an average of eight weeks from their spouses because of marital discord. Men were much more satisfied with the quality of their marriages prior to separation and much more opposed to its ending than were women. Women consistently reported more gains than men as a consequence of their separations and a greater readiness to divorce. Social support systems were stronger in the case of women than men and in the case of parents than nonparents. Formal and informal helpseeking was very common. There was considerable difficulty in the areas of job performance and career planning, and the presence of children appeared to add to the difficulties faced by divorcing parents. In general, while the preseparation period appeared to be more stressful for women, the early postseparation period was far more difficult for men.