Knowledge and attitudes of hospital personell toward older adults.

The Facts on Aging Quiz was given to 693 hospital personnel to examine their knowledge of and attitudes toward older adults. Respondents 40 years of age and over had better knowledge scores than respondents 16-29 years old. Individuals with associate, baccalaureate or graduate degrees had higher knowledge scores than respondents with a high school education. Clinical employees and volunteers had higher knowledge scores than non-clinical employees. Approximately 25% of the hospital personnel exhibited a negative bias (i.e., attitude) toward older adults. Considering the health care utilization of older adults, it is important that all individuals working within a hospital environment exhibit knowledge of and appropriate attitudes toward them. Implications for gerontological education programs based on adult-learning techniques are noted.

Interfacial catalysis and production of a high ratio of leukotriene A4 to 5-HPETE by 5-lipoxygenase in a coupled assay with phospholipase A2.

The activity of purified 5-lipoxygenases (5-LO) shows a requirement for the presence of phosphatidylcholine or other lipids, in addition to Ca2+ and ATP. The enzymatic activity of purified human 5-lipoxygenase was dependent on the ratio of arachidonic acid to phospholipids rather than on the bulk arachidonic acid concentration, suggesting that the concentration of substrate at the lipid-water interface is important for the rate of the 5-LO reaction. Enzyme activity was also examined using vesicles of dimyristoylphosphatidylmethanol/1-palmitoyl-2-arachidonoylphosp hat idylcholine. Using PLA2 to release arachidonic acid from phospholipid, the ratio of leukotriene A4 (detected as trans-LTB4 isomers) to 5-hydroperoxyeicosatetraenoic acid (5-HPETE) accumulated depended on the 5-LO concentration and was relatively independent of the amount of PLA2. The ratio of leukotriene A4 to 5-HPETE production increased with the amount of 5-LO (1-15 micrograms/ml) to reach values (> 10) similar to those observed with ionophore-challenged human leukocytes. The data are consistent with the catalysis of 5-LO occurring at the surface of phospholipid vesicles with the 5-HPETE product being re-utilized by the LTA4 synthase reaction of 5-lipoxygenase under conditions of limiting arachidonic acid availability.

Isolation and characterization of isoprene mutants of Escherichia coli.

Isoprenoid compounds are found in all organisms. In Escherichia coli the isoprene pathway has three distinct branches: the modification of tRNA; the respiratory quinones ubiquinone and menaquinone; and the dolichols, which are long-chain alcohols involved in cell wall biosynthesis. Very little is known about procaryotic isoprene biosynthesis compared with what is known about eucaryote isoprene biosynthesis. This study approached some of the questions about isoprenoid biosynthesis and regulation in procaryotes by isolating and characterizing mutants in E. coli. Mutants were selected by determining their resistance to low levels of aminoglycoside antibiotics, which require an electron transport chain for uptake into bacterial cells. The mutants were characterized with regard to their phenotypes, map positions, enzymatic activities, and total ubiquinone content. In particular, the enzymes studied were isopentenyldiphosphate delta-isomerase (EC 5.3.3.2), farnesyldiphosphate synthetase (EC 2.5.1.1), and higher prenyl transferases.

Biosynthesis of lasalocid A: biochemical mechanism for assembly of the carbon framework.

Labeling experiments on the biosynthesis of the polyether antibiotic lasalocid A (1) using carboxylic acid precursors bearing 13C, 2H, and 3H labels at various positions established the following: (1) 2H or 3H at C-2 of propionate or 2H at C-2 of butyrate was partially retained at C-12 and C-14 of 1, respectively. (2) 2H at C-2 of propionate or at C-2 and C-3 of succinate did not label C-10. These and earlier data [Hutchinson, C. R., Sherman, M. M., Vederas, J. C., & Nakashima, T. T. (1981) J. Am. Chem. Soc. 103, 5953; Hutchinson, C. R., Sherman, M. M., McInnes, A. G., Walter, J. A., & Vederas, J. C. (1981) J. Am. Chem. Soc. 103, 5956] are consistent with a hypothesis for the stereochemical control of lasalocid A biosynthesis, whose main tenets are that the configuration of C-12 and C-14 is determined by the stereoselectivity of the carbon chain forming condensation between acyl thio ester and 2-carboxyacyl thio ester intermediates and that the configuration of C-11 and C-15 results from the reduction of 2-keto thio ester intermediates with opposing stereospecificities.

Biosynthesis of lasalocid A. Biochemical alteration of polyether antibiotic production.

The effect of known precursors, their fluorinated analogs, and biochemical inhibitors on the production of the polyether antibiotic, lasalocid A (1), by resting cells of Streptomyces lasaliensis was determined to study the biochemistry and regulation of antibiotic biosynthesis in vivo.

Biosynthesis of lasalocid A. Metabolic interrelationships of carboxylic acid precursors and polyether antibiotics.

The metabolic interrelationships of isobutyrate, n-butyrate, and propionate in Streptomyces lasaliensis are established to show how these acids are used as precursors for the biosynthesis of the polyether antibiotic, lasalocid A.

Massive arterial tumor emboli during thoracotomy: report of two cases with literature review.

Two patients undergoing thoracotomy for lung cancer sustained fatal intraoperative gross arterial tumor emboli. Thirteen additional cases from the literature are analyzed along with these two new cases. Mortality at 48 hours from thoracotomy was 67%.

Management of penetrating heart wounds.

The records of ninety-two patients treated between 1965 and 1976 at the Boston City Hospital for penetrating wounds of the heart were reviewed and the results were compared with a previous series of twenty-five patients admitted to the same institution between 1956 and 1964. The annual incidence rose from 2.8 cases during the first period to 8.0 during the more recent years. Gunshot wounds increased in frequency in the second period. The overall mortality was similar in the two series. However, there were more complex wounds and agonal patients subjected to immediate emergency room thoracotomy during the second phase of this experience. The salvage rate in the latter group of patients gradually improved and averaged 24% between 1965 and 1976. These data indicate that an aggressive approach, including the use of immediate thoracotomy, to the agonal patient with a heart wound will be rewarded with salvage of some patients.

Managment of thoracic empyema.

Over a ten year period, 102 patients with thoracic empyemata were treated at Boston City Hospital. Only three patients died from the pleural infection while twenty-six succumbed to the associated diseases. Priniciples of management include: (1) thoracentesis; (2) antibiotics; (3) closed-tube thoracostomy; (4) sinogram; (5) open drainage; (6) empyemectomy and decortication in selected patients; and (7) bronchoscopy and barium swallow when the etiology is uncertain.

Autologous blood transfusion during cardiopulmonary bypass.

Immediately prior to cardiopulmonary bypass, two units of blood were removed from each of 25 patients undergoing open-heart surgery, and the autologous blood was reinfused after cessation of support with the pump oxygenator. Pertinent data on blood balance and hematologic measurements were compared to a matched group of control subjects. There were no significant differences in the amount of operative or postoperative bleeding, the requirements for homologous blood and blood products, or the amount of protamine needed for neutralization of heparin.

Hereditary spherocytosis with hemolytic crisis during pregnancy. Treatment by splenectomy.

Hemolytic anemia was detected in 2 young women in the second trimester of pregnancy. The diagnosis of hereditary spherocytosis was made, and the patients underwent uneventful splenectomy. Five similar cases from the literature are reviewed.