Rehabilitation for convicted drinking drivers (second offenders): effects on mortality.

The mortality experience of convicted drinking drivers (second offenders) (N = 347) randomly assigned to rehabilitation and control groups in two Ontario cities was examined. Over a follow-up period ranging between 8 and 13 years, 14 (11.0%) of the controls and 17 (7.7%) of the rehabilitation group died. Direct comparisons of the randomly assigned control and treatment groups revealed a tendency for lower total mortality and significantly lower mortality from accidental and violent death in those assigned to rehabilitation. Additional comparisons involving a combined rehabilitation group (N = 487) (rehabilitation participants randomly and not randomly assigned) confirmed these observations.

Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics.

This study examined the incidence of alcohol and drugs in a sample of seriously injured motor vehicle collision victims, and differences related to pre-crash use of alcohol and/or other drugs on demographic variables, injury severity measures, and crash variables. The sample selected were all motor vehicle collision admissions to the Regional Trauma Unit at the Sunnybrook Health Science Centre in Toronto, Ontario, over a 37-month period (N = 854). Prospective demographic and injury-related information were collected from hospital charts, and crash data were collected from motor vehicle collision police reports. Blood samples were routinely collected on admission and tested for blood alcohol concentration (BAC). We found 32.0% of the BAC-tested motor vehicle collision admissions and 35.5% of drivers tested positive for blood alcohol. The drivers' mean BAC on admission was found to be 145.2 mg/100 ml, and the mean estimated BAC at crash time was 181 mg/100 ml. Drug screens were performed on a two-year subsample (n = 474), of whom 339 were drivers. Drug screens revealed that 41.3% of drivers tested positive for other drugs in body fluids, and 16.5% were positive for alcohol in combination with other drugs. Other than alcohol, the drugs most frequently detected in the drivers were cannabinoids (13.9%), benzodiazepines (12.4%), and cocaine (5.3%). Investigation of differences on demographic, injury, and crash characteristics related to precrash use of alcohol and/or drugs yielded significant findings. In the drug screened sample we found sex, admission type, and occupant status were related to precrash alcohol use. Also, use of drugs was found to interact with admission type and mean BAC on admission. Elapsed time was found to be significantly different for BAC by other drug use, with a greater length of elapsed time found for the subjects testing other drug positive but BAC negative. We found that BAC-positive drug-screened drivers were significantly more likely to be male, involved in a single-vehicle collision, not wearing a seat belt, ejected from the vehicle, and travelling at higher speeds than BAC negative drivers. No significant differences were found between BAC and/or other drug use on injury severity measures.

Characterization and nucleotide sequences of the variable regions of a monoclonal antibody against alpha-fetoprotein.

alpha-Fetoprotein (AFP) is a well-known tumor marker of hepatocellular carcinoma (HCC). Monoclonal antibodies against AFP possessing specific binding ability to HCC are potential candidates for immunoscintigraphy and immunotherapy. A new monoclonal antibody against AFP (0325-6-9) was isolated. Its specificity and targeting tumor ability were characterized by enzyme-linked immunosorbent assay (ELISA), cell immunostain and complement killing. These results suggest that 0325-6-9 is specific to hepatoma cells. The nucleotide sequences of variable regions of 0325-6-9 were determined by M13 dideoxynucleotide sequencing method. With the information of nucleotide sequence, this antibody then could be modified by recombinant technology for its usage in in vivo diagnosis and immunotherapy.

Scabietic nodules: a dermatopathologic and immunofluorescent study.

Mites and their eggs were thought to be rarely found in nodular lesions of scabies. However, serial sections from 27 scabietic scrotal papules or nodules revealed mite parts in 22% (6/27). This supports the contention that scabietic nodules may result from persisting antigens of mite parts. In contrast to previous studies, vasculitis with fibrinoid degeneration was uncommon (3/27) in our series. This discrepancy may be due to the timing of the biopsies: 2 of 3 cases with vasculitis were associated with diffuse dense infiltration, and vasculitis may be a late event in the development of scabietic nodules. The specificity of immunoreactant deposits along the epidermodermal junction (EDJ) in scabies is controversial. In our study, direct immunofluorescence (DIF) was performed on 13 scabietic nodules. Four (31%) showed immunoreactants at the EDJ and two on blood vessels. Because of the relatively low positive rate, the low intensity of fluorescence, and 3 of 4 cases with positive immunoreactants having only a single class of immunoglobulin, the deposition may only be secondary to inflammation instead of a specific type II immunologic reaction to scabies.

Detection and analysis of human papillomavirus type 1 infection of skin warts from a dermatology clinic in Taiwan by southern hybridization.

Thirty cases of skin warts from the Dermatology Clinic at Tri-Service General Hospital were analyzed for the presence of human papillomavirus type 1 sequences by Southern blot hybridization. Thirteen of the 30 cases were HPV-1 positive. The prevalence was 43%. Episomal HPV-1 sequences were detected in 11 of 13 HPV-1 positive cases. There are two cases which probably contained integrated forms, one contained the higher molecular weight bands, and the other with 6 kb viral genome may be the result of rearrangement and deletion. Histological studies from HPV-1 positive specimens also indicated the typical features of HPV infection. Some cases with high copy number had a high frequency of inclusion bodies. Chi-square analysis showed that HPV-1 prevalence is not related to sex and different lesion locations, but the prevalence of HPV-1 in recurrent lesions is higher than that of initial lesions.

Metabolic clearance rate and secretion rate of gastric inhibitory polypeptide in the rat.

The metabolic clearance rates (MCR) and secretion rates (SR) of immunoreactive gastric inhibitory polypeptide (IR-GIP) were determined in both fasted and fed rats by a specific radioimmunoassay (RIA). Rats were infused intravenously (iv) with porcine GIP dissolved in a blood replacement mixture at a constant rate of 0.12-0.13 ml/min for 60 min. The basal level of plasma GIP was decreased in fasted rats as compared to fed rats. The mean MCR of GIP was 1.85 ml/min in fasted rats and 1.96 ml/min in fed rats. There was no significant difference in MCR of GIP between fasted and fed rats. However, the SR was significantly higher in fed rats when compared with fasted rats. These results suggest that the low concentration of plasma GIP in fasted rats is due to a reduction of GIP secretion rate.

Inhibition of somatostatin on glucose-induced release of gastric inhibitory polypeptide in rats.

The effect of somatostatin on glucoseinduced secretion of insulin and gastric inhibitory polypeptide (GIP) in rats was examined. Anesthetized male rats were catheterized via the right carotid artery before gastric infusion of 2 ml of 40% glucose through a syringe pump over 3 min. Ten micrograms somatostatin dissolved in 0.5 ml saline was injected intraperitoneally 10 min before oral glucose administration. Rats receiving 0.5 ml saline were used as controls. Blood samples were collected at -10, 0, 10, 20, 30, 45, 60, and 90 min after glucose infusion. Concentrations of GIP and insulin in rat plasma samples were measured by radioimmunoassay. The level of plasma glucose was determined by YSI glucose analyzer. The results revealed that the rise of plasma insulin and GIP after the glucose load was abolished by a preinjection of somatostatin. It is concluded that somatostatin at 10 micrograms inhibits the effects of oral glucose in stimulating the secretion of GIP from the gut, and insulin from the pancreas in normal fasted rats.

Clinical versus laboratory detection of alcohol abuse: the alcohol clinical index.

To determine reliable indicators of alcohol abuse a comprehensive set of clinical and laboratory information was acquired from three groups of subjects with a wide range of drinking histories: 131 outpatients with alcohol problems, 131 social drinkers, and 52 patients from family practice. Findings from clinical examination provided greater diagnostic accuracy than laboratory tests for detecting alcohol abuse. Logistic regression analysis produced an overall accuracy of 85-91% for clinical signs, 84-88% for items from the medical history, and 71-83% for laboratory tests in differentiating the three groups. Further analyses showed 17 clinical signs and 13 medical history items that formed a highly diagnostic instrument (alcohol clinical index) that could be used in clinical practice. A probability of alcohol abuse exceeding 0.90 was found if four or more clinical signs or four or more medical history items from the index were present. Despite recent emphasis on the laboratory diagnosis of alcohol abuse simple clinical measures seem to provide better diagnostic accuracy.