Infectious mononucleosis; review of complications in hospitalized series.
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Biomedical subjects
Publications and source records attributed to M Fisher.
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We examined the associations of diet and alcohol consumption with levels of high-density lipoprotein (HDL) cholesterol using cross-sectional data from 4855 white participants, ages 20 years and older, seen at visit 2 of the Lipid Research Clinics Prevalence Study. There was a strong positive gradient of HDL cholesterol levels with reported amount of alcohol intake in both men and women, regardless of type of alcoholic beverage consumed. We found a difference in HDL cholesterol levels between the two groups of participants who reported no alcohol consumption during the past week. Those who said that they never drank had lower mean HDL cholesterol levels than those who reported that they did drink but had not consumed any alcohol during the past week. Weaker inverse relations (p < 0.05) were found between HDL cholesterol levels and intakes of total carbohydrate sucrose and starch (percent calories and grams). Dietary saturated, monounsaturated and polyunsaturated fat intakes were unrelated to HDL cholesterol levels; similarly, no association was seen for HDL cholesterol and total calories and total fat. Cholesterol intake (mg and mg/1000 calories) was generally unrelated to HDL cholesterol levels, except in women not taking exogenous gonadal hormones.
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Two regimens to immobilise the knee after injection were compared in patients receiving intra-articular yttrium-90 for persistent synovitis of the knee, the patients being randomly allocated to receive either complete bed rest or full mobilisation with the affected knee in a firm splint. There was no difference in the percentage of the radioisotope retained in the knee or in that taken up by other tissues between the two regimens. It is concluded that after intra-articular injections of yttrium-90 strict bed rest in hospital is unnecessary.
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The plasma concentration of beta-thromboglobulin was estimated in elderly in-patients using a radio-immuno-assay technique. There were highly significance differences between the mean values of patients with arterial or venous thrombosis, as compared with controls. The ability of the test to detect thrombosis above the inguinal ligament means that it is a useful addition to the existing battery of tests for detecting thrombosis.
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Working independently, eight investigators evaluated the clinical effectiveness of fluocinonide 0.05% in a three-week double-blind paired comparison trial of 240 patients. Half the investigators compared fluocinonide emollient cream with betamethasone valerate 0.1% cream in the treatment of atopic dermatitis, while the remaining four compared the study drug with triamcinolone acetonide 0.1% cream in the treatment of psoriasis. Statistical analysis showed clinical responses favored fluocinonide p = 0.021 (Wilcoxon Signed Rank) for the atopic dermatitis group and p = 0.001 (Wilcoxon Signed Rank) for the psoriasis group.
This study demonstrates that the dorsal ectoderm of the stage 14 chick embryo synthesizes hyaluronic acid. About 49 to 52% of the H3 glucosamine-labeled glycosaminoglycan that is synthesized by explanted ectoderm can be identified as hyaluronic acid on the basis of its susceptibility to Streptomyces hyaluronidase or isolation of chondroitinase ABC digestion products. In addition, autoradiographic evidence shows that the ectoderm, unlike adjacent tissues like epithelial somites or neural tube, incorporates glucosamine into hyaluronidase-sensitive material which becomes largely extracellular and localized in the subectodermal cell-free space. Ultrastructural evidence shows that there is a fine fibrillar matrix between the ectodermal cells and in the subectodermal spaces when tannic acid is included in the primary fixative. This material resembles authentic hyaluronate, similarly fixed, and is absent when tannic acid is omitted from the fixative or when embryos have been previously treated in ovo with Streptomyces hyaluronidase. The concomitant reduction in the intercellular and subectodermal cell-free spaces after in ovo treatment with Streptomyces hyaluronidase supports the hypothesis that the dorsal ectoderm plays a morphogenetic role by contributing hyaluronate to the forming extracellular spaces. It is proposed that ectodermally derived hyaluronate might influence the morphogenesis of subjacent tissues such as the dermatome and neural crest.
Intra-articular injections of erbium--169 citrate and methylprednisolone acetate in hand joints were compared in a randomly selected double-blind trial. The patients included 21 with rheumatoid arthritis and 3 with psoriatic arthritis, and the design was an intrapatient comparison. No difference between joints treated with the radioisotope or steroid was observed in the year following injection.
We present a family with infantile onset of progressive choreoathetosis. The movements affected the legs predominantly and also impaired gait. No dementia, seizures, or rigidity was noted. Inheritance was autosomal dominant. This new familial movement disorder can be differentiated easily from other hereditary choreas.
Limb, somite, and neural crest mesenchyme from quail embryos were implanted orthotopically and heterotopically into chick hosts to ascertain the relative importance of the local environment on mesenchyme migration. It was found that mesenchyme behavior is strongly influenced by the environment. Normally non-migratory, limb mesenchyme is capable of spreading like sclerotome when placed in the somite region. A somite placed in the limb acquires an appearance typical of limb mesenchyme. Neural crest placed in the limb migrates only along the co-implanted neural tube or axons growing out from it. The orthotopic transplantations showed that quail mesenchyme behaves normally in chick embryos. Furthermore, it was observed in the orthotopic transplants that there was no intermingling of quail and chick cells even at the edge of the graft. This result indicates that cells within mesenchyme are normally not locomotory; rather, the mesenchyme "migrates" by spreading and expansion of the tissue as a unit in response to local influences.
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The development of the sclerotome is considered as a model for the formation of mesenchyme from an epithelium. In early epithelial somites, transmission and scanning electron microscopy indicate considerable ultrastructural similarity between the future sclerotome and dermamyotomal regions. Subsequently, these two regions diverge in their development. In the forming dermamyotome, junctional complexes become more extensive and the cells become elongated, closely applied to each other, and have angular surface contours. In the forming sclerotome, there is an early reduction in apical junctions. The cells elongate, keeping their original polarity, and acquire numerous filopodia which contain punctate junctions at sites of cell-to-cell contact. Associated with cellular extension is an expansion of the intercellular spaces which do not contain any ultrastructurally recognizable material. Evidence for a role of hyaluronic acid in the expansion of the intercellular spaces is presented. As identified by the susceptibility of cetylpyridinium chloride precipitates to Streptomyces hyaluronidase and chromatographic separation of chondroitinase ABC digestion products, as much as 64--68% of the [3H]glucosamine-labeled glycosaminoglycans synthesized by explanted somites is hyaluronic acid. In addition, hyaluronidase-sensitive label is localized in the intercellular spaces of the sclerotome, as demonstrated by autoradiography. When Streptomyces hyaluronidase is injected in ovo into living embryos, the sclerotomal mesenchyme differentiates morphologically, but intercellular spaces are drastically reduced. It is hypothesized that the sclerotomal cells produce a hyaluronate-enriched extracellular matrix which is inflated by hydration to mediate the expansion of the sclerotomal mass towards the notochord.