Factors related to driving in persons with an implantable cardioverter defibrillator.

A study of 97 persons (mean age = 66 yrs, 79% male) with an ICD for an average of 2.2 years was conducted to determine whether patients resume driving (N = 72) post-ICD insertion despite instructions not to do so. Those who had resumed were queried about their driving habits, the presence of symptoms associated with arrhythmias, the occurrence of shocks in the previous year, and the importance of driving to maintenance of lifestyle. Our assumption was that patients return to driving to maintain their pre-ICD lifestyle of functional independence, and to resume social roles such as provider for the family. Seventy-four percent of subjects reported driving an average of 60 mi/week despite being instructed not to drive by their physician or other health care provider. Of those who resumed driving, > 4% had received a shock while driving. Over 86% of subjects believe driving was an important part of maintaining one's lifestyle. Reasons for driving included necessity (62%), such as to work or a physician appointment, or social (58%), such as driving to the store or church. Symptoms such as dizziness, palpitations and lightheadedness were experienced by 80% of subjects, with 43% receiving a shock from their ICD within the previous year. There were significant correlations between driving and the importance of driving to maintaining one's lifestyle (p < .05), driving for necessity (p < .01), for social reasons (p < .01) and being the primary driver in the family (p < .05).

Analysis of human leukemic cells by use of high-resolution two-dimensional electrophoresis. I: results of a pilot study.

We analyzed mononuclear leukocytes from patients with various human leukemias by high-resolution two-dimensional electrophoresis. Tumor cells of the granulocytic, monocytic, and lymphoid lineages [obtained from chronic granulocytic leukemia in blast transformation, acute monocytic leukemia, and chronic lymphocytic leukemia (CLL), respectively] can be easily recognized by using a series of cell-type marker proteins identified by comparison of fractionated normal cell populations. B and T cell types of CLL could be distinguished, the results correlating well with those obtained by use of monoclonal-antibody staining methods. In two cases representing almost pure B-cells (classical CLL; 0% T, 85% B) and T-cells (cutaneous T-cell leukemia; 77% T, 0% B), 27 of 29 marker proteins showed quantitative B/T differences comparable to those observed in comparisons of normal B-and T-lymphocytes prepared by cell sorting. These results indicate that cells from relatively well-differentiated leukemias show complex patterns of gene expression very similar to those of the corresponding normal cells and strongly support the use of large marker panels in cell-type determination. Less-well-differentiated acute leukemias [such as acute undifferentiated and acute granulocytic (FAB:M1)] appear to yield protein patterns corresponding less closely to recognizable mature cell types, and may show expression of novel proteins related to the state of differentiation.

Proteins of human milk. I. Identification of major components.

Traditionally, human milk proteins are identified largely by reference to bovine milk. Hence, to identify the major proteins in human milk, we subjected human and bovine milk, in parallel, to high-resolution two-dimensional electrophoresis. Isoelectric precipitation at pH 4.6 was our criterion for distinguishing whey proteins from those of the casein complex. The alpha- and beta-caseins were identified on the basis of relative abundance, relative molecular mass, and relative isoelectric points. Kappa casein was identified as a series of four spots, which disappear from bovine skim milk treated with rennin (chymosin; EC 3.4.23.4) during the clotting process. Para kappa-casein does not appear on the standard ISO-DALT pattern after treatment of bovine milk with rennin, but does appear in BASO-DALT pattern, indicating its high isoelectric point. No protein disappeared from ISO-DALT patterns of human milk after rennin treatment, and no new protein comparable to bovine para kappa-casein appeared in the BASO-DALT patterns; this suggests that kappa-casein is absent from human milk. The proteins identified in human milk patterns include the alpha and beta casein families, lactalbumin, albumin, transferrin, IgA, and lactoferrin. Numerous additional proteins seen in patterns for human milk remain to be identified.