Studies of growth hormone/insulin-like growth factor-I in polio survivors.

In the later years of life, many polio survivors develop post-polio syndrome manifested by progressive muscular weakness. Previous work by the authors showed low IGF-I level in polio survivors compared to age-matched controls. IGF-I concentration tended to be lower in polio survivors who were older, male, obese, and also in persons experiencing difficulty in the activities of daily living which were independent of other factors. IGF-I levels did not correlate with the subjective report of recent decline in functional status. Further studies of nocturnal GH secretion indicated that low IGF-I level was secondary to impaired growth hormone secretion. Low IGF-I levels in subjects with post-polio syndrome were corrected by physiologic doses of hGH and the response was dose dependent. Lesser dosage was required to normalize IGF-I level compared to standard dosages previously used in younger persons. Inasmuch as low IGF-I level resulting from GH deficiency is known to be associated with weakness, muscle atrophy, and decrease in aerobic work capacity, it is postulated that low IGF-I levels that occur in aging polio survivors may have an adverse effect on their neuromuscular function, and that hGH replacement may improve their functional status. Moreover, the new dose-response data may decrease the frequency of side effects in future hGH treatment of older adults.

DNA markers tightly linked to a gall midge resistance gene (Gm2) are potentially useful for marker-aided selection in rice breeding.

We have developed a polymerase chain reaction (PCR)-based assay that could effectively reduce the time period required to screen and select for Gall Midgeresistant rice lines under field conditions. The primers for the assay were designed on the basis of sequence information of two phenotype specific random amplified polymorphic DNA fragments which were found to be tightly linked to Gall Midge biotype-1 resistance gene (Gm2). The two RAPD fragments, F81700 in the susceptible parent 'ARC6650' and F10600 in the resistant parent 'Phalguna', were identified after screening 5450 loci using 520 random primers on genomic DNAs of 'ARC6650' and 'Phalguna'. These primers, when used in a multiplexed PCR, amplified specifically a 1.7-kb and 0.6-kb fragment in the susceptible and resistant parents, respectively. When this assay was performed on genomic DNAs of 44 recombinant inbred lines derived from 'ARC6650' x 'Phalguna' and 5 lines derived from other crosses where one of the parents was 'Phalguna', 'ARC6650' or their derivatives, the primers amplified a 1.7-kb fragment in all of the susceptible lines or a 0.6-kb fragment in all of the resistant ones. These markers can be of potential use in the marker-aided selection of Gall Midge biotype-1 resistant phenotypes. As screening for resistance can now be conducted independent of the availability of insects, the breeding of resistant varieties can be hastened.

RFLP and RAPD mapping of the rice gm2 gene that confers resistance to biotype 1 of gall midge (Orseolia oryzae).

Gm2 is dominant gene conferring resistance to biotype 1 of gall midge (Orseolia oryzae Wood-Mason), the major dipteran pest of rice. The gene was mapped by restriction fragment length polymorphism (RFLP) analysis of a set of 40 recombinant inbred lines derived from a cross between the resistant variety 'Phalguna' and the susceptible landrace 'ARC 6650'. The gene is located on chromosome 4 at a position 1.3 cM from marker RG329 and 3.4 cM from RG476. Since the low (28%) polymorphism of this indica x indica cross hindered full coverage of the genome with RFLP markers, the mapping was checked by random amplified polymorphic DNA (RAPD)/bulked segregant analysis. Through the use of 160 RAPD primers, the number of polymorphic markers was increased from 43 to 231. Two RAPD primers amplified loci that co-segregated with resistance/susceptibility. RFLP mapping of these loci showed that they are located 0.7 cM and 2.0 cM from RG476, confirming the location of Gm2 in this region of chromosome 4. Use of these DNA markers will accelerate breeding for gall midge resistance by permitting selection of the Gm2 gene independently of the availability of the insect.

Continuous nasogastric morphine infusion.

Morphine sulfate is the narcotic analgesic most commonly used for pain treatment in terminally ill patients. This case report demonstrates a new method of morphine administration. A 56-year-old terminally ill cancer patient with severe pain from metastatic adenocarcinoma of the lung required continuous nasogastric feeding and around-the-clock narcotic analgesics. The patient was safely and effectively converted from a continuous intravenous morphine infusion to continuous nasogastric morphine-enteral feedings. This method of administration may benefit patients receiving continuous enteral tube feedings who either require high-dose morphine therapy or are unable to use the oral administration route.

Diverticulitis manifesting as transverse colocutaneous fistula: report of a case and review of literature.

A case of spontaneous colocutaneous fistula arising from the transverse colon is reported and the literature is reviewed.

A diagnostic approach to occult blood in the stool.

Occult blood in the stool may be the first sign of otherwise asymptomatic colorectal cancer or other gastrointestinal disease. All patients over 40 should therefore have a rectal examination that includes a Hemoccult slide test. A rational diagnostic plan is essential to identify the source of occult blood in the stool. Most gastrointestinal cancer is operable if diagnosed early, so early detection of these lesions is imperative.

A correlative study of duodenal aspirate and faeces examination in giardiasis, before and after treatment with metronidazole.

In a study of 95 patients with giardiasis it was shown that examination of duodenal aspirates for Giardia Lamblia can supplement but not replace examination of faeces in the detection and follow-up of cases. The chances of finding trophozoites in duodenal aspirate is greater in those with trophozoites in the faeces than in cyst passers. Patients were treated with metronidazole in either conventional dosage (400 mg.t.d.s. for 7 days) or with a single 'hammer dose' of 2400 mg. Results showed that the parasites may persist in the duodenum and faeces after conventional therapy, though the incidence was not very high; and it is suggested that a single large dose of metronidazole may be equally if not more effective than divided doses spread over a few days.