Picosecond investigation of the collisional deactivation of OH A 2Sigma+(v' = 1, N' = 4, 12) in an atmospheric-pressure flame.

The collisional deactivation of the laser excited states A 2Sigma+(v' = 1, N' = 4, 12) of OH in a flame is studied by measurement of spectrally resolved fluorescence decays in the picosecond time domain. Quenching and depolarization rates, as well as vibrational energy-transfer (VET) and rotational energy-transfer (RET) rates are determined. An empirical model describes the temporal evolution of the quenching and VET rates that emerge from the rotational-state relaxation. Fitting this model to the measured 1-0 and 0-0 fluorescence decays yields the quenching and VET rates of the initially excited rotational state along with those that correspond to a rotationally equilibrated vibronic-state population. VET from the higher rotational state (N' = 12) shows a tendency for resonant transitions to energetic close-lying levels. RET is investigated by analysis of the temporal evolution of the 1-1 emission band. The observed RET is well described by the energy-corrected sudden-approximation theory in conjunction with a power-gap law.

Vertical transmission of HIV in New York State: a basis for statewide testing of newborns.

Infants (n = 313) of HIV-infected mothers were enrolled (mean age 1.9 weeks, range 0-8 weeks) in a 3-year prospective study of vertical transmission. Fifty-six infants (17.9%) had laboratory and clinical evidence of HIV infection. Polymerase chain reaction (PCR) provided early and reliable identification of infected infants. Thirty-one of the 56 infected infants had specimens submitted when the infants were 4 weeks of age or less and 30 (97%) tested PCR positive. This percentage increased to 100% by 8 weeks of age when 51 of the 56 infected infants had specimens tested for that time period. Immune complex dissociation (ICD) antigen testing was a sensitive method for diagnosis of infection but only in infants older than 1 month. p24 antigen testing, although free of false positives, is less sensitive than either of the other methods. Among surrogate markers of HIV infection, elevation of soluble CD8 levels precedes an increase in immunoglobulin levels or a decline in CD4 T lymphocytes. Vertical transmission is significantly lower in Central and Western New York State than other regions. Transmission is significantly higher in low birthweight babies and in infants whose mothers have CD4 counts < 500. This study provided the basis for establishing a Pediatric HIV PCR Testing Service for the early diagnosis of HIV infection in neonates.

Phase-conjugate resonant holographic interferometry applied to NH concentration measurements in a two-dimensional diffusion flame.

Resonant holographic interferometry is a diagnostic technique based on the dispersion of light having a frequency close to that of an electronic transition of a molecule. We propose a novel single-laser, two-color setup for the recording of resonant holograms and apply it to two-dimensional (2D) species concentration measurements in a combustion environment. The generation of the second color is achieved by optical phase conjugation from stimulated Brillouin scattering in a cell. The frequency shift of ~8.5 GHz introduced by the phase conjugation matches approximately the linewidth of many molecular transitions at typical flame temperatures and can be implemented to produce holograms of good contrast and diffraction efficiency. Phase-conjugate resonant holographic interferometry is demonstrated in a 2D NH(3) -O(2) flame, yielding interferograms containing information on the NH radical concentration distribution in the flame. Experimental results are quantified by application of a numerical computation of the complex refractive index.

[Pituitary apoplexy after injection of pituitary-hormone releasing hormones]. / Hypofysaer apopleksi etter injeksjon av hypotalamiske frigjørende hormoner.

Pituitary apoplexy often occurs spontaneously in adenomas. A few cases have been reported after testing anterior pituitary function by means of intravenous injections of a mixture of gonadotropin-releasing hormone and thyrotropin-releasing hormone, or gonadotropin-releasing hormone alone. In these cases the development of visual field defects has necessitated surgical intervention, which confirmed pituitary apoplexy. We describe a patient with a pituitary macroadenoma. He developed symptoms and signs of pituitary apoplexy immediately after intravenous injection of a mixture of hypothalamic releasing hormones. His visual fields remained normal, and he recovered spontaneously.

[Thyroid dysfunction and thyroid antibodies in a population group over the age of 70. A prevalence study from Oslo and Naeröy]. / Thyreoideadysfunksjon og thyreoideaantistoffer i befolkningsgrupper over 70 år. Prevalenseundersøkelser fra Oslo og Naerøy.

The prevalence of thyroid dysfunction and thyroid antibodies was investigated in a small rural community (Naerøy) and in Oslo. Attendance rates in Naerøy and Oslo were 99 and 71%, respectively. The prevalence of undiagnosed latent hypothyroidism and primary hypothyroidism was 4.0 and 5.3% in women in Oslo and Naerøy respectively and 0 and 3.5% in men. Undiagnosed hyperthyroidism was detected in 1.2% of men in Naerøy and in 1% of women in Oslo. Antibody to the thyroid microsomal antigen in titre greater than or equal to 400 was detected in 10.2 and 17.5% of women and 7.3 and 7.2% of men in Oslo and Naerøy, respectively. Among women with antibody to the thyroid microsomal antigen in both Oslo and Naerøy, and among men in Naerøy, the prevalence of past or present thyroid dysfunction was increased.

Prevalence of thyroid dysfunction in elderly subjects. A randomized study in a Norwegian rural community (Naerøy).

The prevalence of thyroid dysfunction was investigated in a small, rural community located at the coast in Middle Norway. Two hundred persons (114 women and 86 men) of the total 802 persons over 70 years of age in the community were examined regarding thyroid dysfunction. Blood samples were drawn from 197 (113 women and 84 men). In women previously diagnosed hypothyroidism was found in 3.5% and previously diagnosed hyperthyroidism in 0.9%. In men no previously diagnosed thyroid disease was found. Undiagnosed primary hypothyroidism (TT4 less than 70 nmol/l and TSH greater than 6 mU/l) was found in 1.8% and 1.2% of women and men, respectively. Latent hypothyroidism (TT4 70-150 nmol/l and TSH greater than 6 mU/l) was found in 3.5% and 2.4%, and borderline hypothyroidism (TSH 4.5-6.0 mU/l) in 3.5% and 2.4%, respectively. Undiagnosed hyperthyroidism was not found in women but in 1.2% of men. Antibody to the thyroid microsomal antigen (TMA) greater than or equal to 400 was detected in 17.5% of women and 9.6% of men. Clearly elevated serum thyrotropin (TSH) concentrations or previously diagnosed thyroid disease were found in 21.7% and 37.5% of the TMA positive women and men, respectively.

Pathologic features of cytomegalovirus retinopathy after treatment with the antiviral agent ganciclovir.

Ganciclovir is a new antiviral compound (also called BW B759U, DHPG, BIOLF-62, and 2'NDG) that has been used for the treatment of cytomegalovirus (CMV) retinopathy in immunocompromised patients (bone marrow recipients or acquired immune deficiency syndrome [AIDS] victims). The authors studied the eyes of three AIDS patients with CMV retinopathy who died while receiving ganciclovir chemotherapy. Gross, microscopic, and ultrastructural studies of these cases showed varying degrees of retinal scarring and active CMV lesions at the margins of the scars. CMV antigens were localized in cells at all layers of retina at the border of the lesions and in isolated cells in a perivascular location within histologically normal appearing retina. These areas probably represent sites of recrudescence when the drug is discontinued. In situ hybridization using a cloned complementary DNA (cDNA) probe of human CMV corroborated the immunocytologic localization of the virus. Ultrastructural studies showed megalic syncytial cells containing mostly capsids exclusively in the cell nucleus. The cytoplasmic electron-dense membrane-bound bodies that have characterized untreated cases of CMV retinopathy were absent in the treated cases. An attempt to isolate CMV in tissue culture from the vitreous and retina of one of the cases yielded a negative result. Our results indicate that ganciclovir does not effectively eliminate CMV from the retina nor does it suppress expression of all viral genes. Ganciclovir appears to function by limiting viral DNA synthesis and subsequent packaging of viral DNA into infectious units, thereby acting as a virostatic chemotherapeutic agent.

Primary hypothyroidism followed by hyperthyroidism. Five case reports.

Five patients are described, who developed primary hypothyroidism between 25 and 57 years of age. They were all adequately treated with L-thyroxine. Graves' disease developed six months to 34 years later. Two had TSH binding inhibiting immunoglobulin (TBII) in their serum at this stage. All were treated with carbimazole, and 3 have experienced relapse upon withdrawal. Our patients are discussed in relation to the 16 cases previously reported. The pathogenesis of this condition is open to speculation.

Influence of dopaminergic inhibition on serum levels of thyrotrophin and prolactin in patients with hypothyroidism before and after prolonged oral administration of TRH.

Forty mg TRH/day given orally for 3 weeks to 8 patients with mild primary hypothyroidism decreased serum TSH from a mean of 4.0 ng/ml +/- 1.2 (SE) to 2.0 ng/ml +/- 0.4 (49%), and their mean incremental TSH response to iv TRH was equally reduced from 8.6 ng/ml +/- 2.5 to 4.0 ng/ml +/- 1.9 (46%). In the same patients serum Prl was 8.2 ng/ml +/- 2.2 before oral TRH treatment and 6.6 ng/ml +/- 1.5 (81%) after treatment, and the mean incremental Prl response to iv TRH was reduced from 43.5 ng/ml +/- 5.0 to 35.9 ng/ml +/- 7.5 (83%). The oral administration of 10 mg of the dopamine antagonist metoclopramide increased mean serum TSH from 0.6 ng/ml +/- 0.1 (SE) to 0.7 ng/ml +/- 0.1 (120%) in euthyroid subjects and from 4.0 ng/ml +/- 1.2 to 5.7 ng/ml +/- 1.6 (145%) in patients with primary hypothyroidism, and mean serum Prl from 8.6 ng/ml +/- 0.8 to 109.5 ng/ml +/- 24.3 (1251%) and from 8.2 ng/ml +/- 2.2 to 119.6 ng/ml +/- 45.5 (1460%), respectively. The incremental TSH responses to iv TRH increased 2.3-fold in euthyroid subjects pre-treated with metoclopramide, while no change was observed in the TSH responsiveness in patients with primary hypothyroidism following metoclopramide pre-treatment. In the euthyroid subjects metoclopramide treatment had no effect on the Prl response to iv TRH.(ABSTRACT TRUNCATED AT 250 WORDS)

Coexistent primary empty sella syndrome and hyperprolactinemia. Report of 11 cases.

The series involved 11 women with concurrent hyperprolactinemia and primary empty sella syndrome. Eight had amenorrhea and six had galactorrhea. All 11 patients had intact hypothalamic-pituitary function, except for having elevated prolactin levels that ranged from 33 to 498 ng/mL. One patient had primary hypothyroidism. Radiologic investigations included sellar polytomography in eight cases, computed tomography of the head in eight cases, bilateral carotid angiography in six cases, and pneumoencephalography in three cases. Of eight patients undergoing transsphenoidal exploratory surgery, one had a pituitary microadenoma and an empty sella while seven had only an empty sella with a flattened pituitary gland. Conventional histologic methods (seven cases) and immunocytologic studies (three cases) of the pituitary gland showed no abnormalities. The cause of this syndrome is unknown. It should be recognized that hyperprolactinemia, with or without galactorrhea-amenorrhea, may occur in association with an empty sella in the absence of an associated pituitary tumor.

A critical evaluation of energy expenditure estimates based on individual O2 consumption/heart rate curves and average daily heart rate.

To test the applicability of indirect estimation of daily energy expenditure from average daily heart rate (HR) and individual O2-intake/heart rate (VO2/HR) regression lines in subjects with metabolic disorders, VO2/HR regression lines were determined on 2 consecutive days in 17 subjects (five healthy, five with obesity, five with untreated thyrotoxicosis, two with anorexia nervosa). Daily energy expenditure was calculated by means of the average 24 h HR. Generally, there was a high correlation coefficient for the relationship between VO2 and HR, but the slopes and intercepts varied considerably from day to day, leading to poor agreement between duplicate estimates of energy expenditures, and not infrequently to physiologically meaningless values. Further studies, comprising determination of the VO2/HR regression lines in three different body positions on 7 different days in one experienced test subject showed great variability of the VO2/HR regression lines, both in the same position and in different positions. The applied procedure seems unsuitable for metabolic studies in individual patients who engage in ordinary daily activities with low energy expenditure.

TSH unresponsiveness, a case report.

A patient with congenital primary hypothyroidism is presented. His thyroid gland had a normal uptake of radioiodine which was independent of endogenous or exogenous TSH, sympathetic B-receptor blockade or prostaglandin inhibition. Infusion of dibuturyl-cyclic AMP increased the uptake of radioiodine and stimulated release of protein bound 131I. He had no goitre even when he did not receive thyroxine, but thyroid histology showed evidence of active epithelium in the presence of adequate substitution with thyroxine. We assume that some unknown factor other than TSH stimulates part of the glandular function in this patient, without leading to adequate formation and release of thyroid hormone.

Fatal reaction to dapsone during treatment of leprosy.

A Burmese boy being treated with dapsone (diaminodiphenylsulfone [DDS]), 100 mg daily, for lepromatous leprosy had a fatal reaction to the drug 3 weeks after therapy was started. The clinical symptoms and progression of illness conform well to a "DDS syndrome" first described in the early 1950s. Although the syndrome clinically resembles infectious mononucleosis, neither Epstein-Barr virus nor cytomegalovirus was implicated as an etiologic agent in this case. The syndrome has been recognized during initiation of dapsone therapy for lepromatous leprosy and has led to the use of a prolonged induction period with initial dosages as low as 25 mg/week. However, because dapsone resistance has been recognized in some strains of Mycobacterium leprae, slow induction of therapy has been replaced with the schedule used for this patient. This report of a fatal reaction to dapsone emphasizes the need for caution when initiating therapy with the drug at full dosage.

Rapid diagnosis of varicella-zoster virus infections by countercurrent immunoelectrophoresis.

A simple, accurate, and rapid method for laboratory diagnosis of varicella-zoster virus (VZV) infections using countercurrent immunoelectrophoresis (CIE) is described. CIE uses zoster convalescent-phase serum to detect VZV antigen in vesticular fluid. Eighty-six patients were studied, 58 with VZV infections and 28 with vesicular or bullous rashes due to causes other than VZV infection. All patients with documented VZV infection had positive CIE tests for VZV, and the controls were uniformly negative. VZV antigen could be detected up to 15 (varicella) or 16 (zoster) days after the onset of rash. The sensitivity of CIE for detection of VZV antigen was compared with results of viral isolation, immune adherence hemmagglutination, and an indirect enzyme-linked immunosorbent assay.

Atypical measles syndrome: unusual hepatic, pulmonary, and immunologic aspects.

The atypical measles syndrome is a relatively new disease that was first recognized 15 years ago. Initially, it occurred in children who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. It was characterized by a two- to three-day prodrome of high fever, cough, headache, and myalgia followed by a rash that resembled Rocky Mountain spotted fever, scarlet fever, or varicella and associated with roentgenographic evidence of pneumonia with or without pleural effusion. This report highlights three unusual manifestations of this syndrome: 1) transient hepatitis, 2) persistence of pulmonary lesions for several years, and 3) occurrence of excessively high measles hemagglutination-inhibition antibody titers. Today, this syndrome occurs predominantly in adolescents and young adults.

Lack of effect of somatostatin on thyroid gland function in Graves' disease.

Five women with Graves' disease, 26-52 years of age, with serum concentrations of triiodothyronine (T3) 4.8-9.2 nmol/l and thyroxine (T4) 200-320 nmol/l were studied. A 26 h infusion of cyclic somatostatin (Bachem), 6 mg in isotonic saline solution was administered. Radioactive iodine i.v. (125I or 131I) was given immediately after the start of this infusion. Serum T3, T4 and conversion rate (CR% = PBRI: total RI X 100) were determined four times during the infusion, then daily for a week. The same studies, related to an injection of radioiodine, were performed during a control week when no somatostatin was administered. Arginine-stimulated insulin and growth hormone (hGH) concentrations were considerably lowered by the somatostatin infusion. No difference in serum T3, T4 or CR between the week that started with somatostatin infusion and the control week was observed. Twelve-26 h after the somatostatin infusion started, all patients experienced gastrointestinal symptoms, which lasted 2-6 h after somatostatin withdrawal. Somatostatin in the dose given does not inhibit thyroid gland function in Graves' disease.

Iodine induced thyrotoxicosis in apparently normal thyroid glands.

Two male patients aged 36 and 52 years with thyrotoxicosis revealed a serum T3 of 2.8 and 6.5 nmol/l and a serum T4 of 166 and 238 nmol/l, respectively. Both had been exposed to iodine (2-10 mg daily) for 2-12 months before thyrotoxicosis was diagnosed. Urinary iodine excretion was high, 5000 and 10,000 nmol/24 h (624-1250 microgram). The uptake of 131I in the thyroid glands were low, none had goitre. Their iodine intake was interrupted, urinary iodine excretion gradually decreased, and T3 and T4 in serum concomitantly normalized. They were clinically and biochemically euthyroid 9 and 11 weeks after withdrawal. After 14 and 22 weeks they had normal thyroid uptake of 131I, and thyroid scans showed glands of normal size and configuration. TRH-stimulation and a T3-suppression tests became normal. ESR was not elevated in any of the cases, thyroid antibodies against thyroglobulin and follicular cell microsomes were absent and TSAb was undetectable durng the thyrotoxic stage. Thus no evidence of any pre-existing and/or pre-disposing pathological condition in the thyroid glands were found. The mechanism for the iodine-induced thyrotoxicosis in such cases remains obscure.