The effect of CO2 laser laparoscopy for treatment of pelvic endometriosis on serum concentrations of antiendometrial antibodies.

This study uses antiendometrial antibodies as an indicator for follow-up of patients with endometriosis after surgical treatment. This is a prospective study of 32 patients with endometriosis. The patients were used as their own controls. Serum samples were obtained before surgery and 1 month, 3 months, and 6-9 months following surgery. All patients were treated with CO2 laser laparoscopy. Serum concentrations of antiendometrial antibodies decreased significantly at 1 month, 3 months, and 6-9 months following treatment in each group. There was no correlation between baseline concentration of antibodies and stage of the disease. This study confirms the value of using antiendometrial antibodies as an indicator for follow-up of endometriosis patients. Surgical treatment with CO2 laser laparoscopy is effective in lowering the antigenic effect of the disease in these patients. This beneficial effect is maintained for up to 9 months after treatment.

RNA from normal anterior endoderm/mesoderm-conditioned medium stimulates myofibrillogenesis in developing mutant axolotl hearts.

In the axolotl, Ambystoma mexicanum, a recessive cardiac lethal mutation causes an incomplete differentiation of the myocardium. Mutant hearts do not contain sarcomeric myofibrils nor do they beat. We have previously shown that normal anterior endoderm, medium conditioned by endoderm, or total RNA extracted from endoderm stimulates differentiation of mutant hearts in culture as indicated by the presence of organized myofibrils and rhythmic contractions of the "rescued" mutant heart tube. In this study, to get a more highly purified sample of the "active" molecule, RNA extracted from endoderm-conditioned medium and was assayed for its ability to promote myofibrillogenesis in mutant hearts. Mutant heart mesoderm responded to conditioned-medium RNA in a dose-dependent manner. Proteinase K treatment of the RNA did not affect inductive activity, while digestion with RNase A completely abolished the ability to rescue mutant hearts. Confocal laser scanning microscopy of immunostained, organ-cultured hearts revealed that mutant hearts contain reduced amounts of the sarcomeric protein tropomyosin in an amorphous distribution, whereas normal and corrected mutant hearts contain tropomyosin primarily in organized myofibrils.

The outer membrane of Pasteurella multocida 3:A protects rabbits against homologous challenge.

The protective efficacy of a vaccine purified from the Pasteurella multocida 3:A outer membrane (OM) was evaluated in rabbits by homologous challenge. Twenty-seven rabbits were divided into four groups: 1, vaccinated with OM and challenged; 2, nonvaccinated and challenged; 3, vaccinated with OM only; and 4, nonvaccinated and not challenged. Rabbits were immunized intranasally with 1 mg of OM protein on days 0, 7, 14, and 35, challenged intranasally on day 49, and killed on day 63. Mortality rates were 0, 67, 0, and 0% for groups 1 through 4, respectively. The prevalence of pneumonia was reduced from 73 (group 2) to 20% (group 1). The severity of pneumonia was reduced from 0.62 (group 2) to 0.07 (group 1), as measured by the group lesion index. The number of P. multocida in nasal cavities was reduced from 3.89 x 10(5) (group 2) to 6.19 x 10(2) (group 1). The geometric mean number of P. multocida in lungs was 8,360,000-fold less in group 1 than in group 2. Similarly, the prevalence of P. multocida colonization in nonrespiratory organs was reduced from 47 (group 2) to 4% (group 1). Furthermore, group 1 and 3 rabbits developed significantly elevated immunoglobulin A antibodies in nasal secretions and lung lavages and significantly elevated immunoglobulin G antibodies in lung lavages and sera. In addition, rabbit immune sera contained antibodies against P. multocida OM proteins and lipopolysaccharides and inhibited P. multocida proliferation in mouse lungs. These results indicate that a vaccine prepared from the OM of P. multocida provides a significant protection in rabbits against homologous challenge.

Significance of aberrant immunophenotypes in childhood acute lymphoid leukemia.

Leukemic cells from 51 pediatric patients (younger than 18 years) diagnosed with acute lymphoid leukemia by standard morphologic and cytochemical methods were subjected to flow cytometric studies using a panel of monoclonal antibodies against T-cell (CD1, 2, 3, 4, 5, 7, 8), B-cell (CD10, 19, 20, 21), myeloid (CD13, 14, 15, 33), and HLA-DR antigens. Cases of "conventional" acute lymphoid leukemia (leukemic cells with a normal configuration of B-cell or T-cell differentiation antigens) were observed in 26 of 51 (51%) cases, whereas cases of "aberrant" acute lymphoid leukemia (cells with abnormal patterns of B-cell or T-cell antigens or with concomitant myeloid antigens) were noticed in 25 (49%) cases. Myeloid antigen-positive acute lymphoid leukemia was observed in the leukemic cells of eight (16%) individuals. No significant differences were observed between conventional and aberrant ALL in the distribution of sex, age, leukocyte count, hemoglobin concentration, platelet count, blast count, French-American-British (FAB) type, lymphadenopathy, organomegaly, rate or duration of remission, or survival. When only myeloid antigen-positive cases were compared with myeloid antigen negative-cases, no significant correlations were observed except for duration of first remission (myeloid antigen positive, 26+ +/- 22 months; myeloid antigen negative, 40+ +/- 18 months; P less than 0.001), and duration of survival (myeloid antigen positive, 27+ +/- 24 months; myeloid antigen negative, 62+ +/- 17 months; P = 0.001). These data suggest that pediatric patients with ALL blasts possessing myeloid antigens may represent a high-risk group for length of remission and survival.

Argon laser laparoscopy for treatment of pelvic endometriosis associated with infertility and pelvic pain.

Argon laser laparoscopy was used for treatment of 46 patients with pelvic endometriosis. Infertility was the primary diagnosis in 31 patients, and pelvic pain was the primary diagnosis in 21 patients. A 600 mum laser fiber was used through the operative channel of the laparoscope, and the tip of the fiber was kept at a distance of 2-3 mm from the lesions. The power density used varied between 1604 and 1069 W/cm 2 at the tissue level. The pregnancy rate following treatment of the infertile group was 42%. Eighty-four percent of these pregnancies occurred within the first 8 months of treatment. In the group with pelvic pain, 8 patients experienced complete pain relief, and 13 patients experienced partial pain relief. Difficulties with the use of the fiber included breakage in 3 patients and melting of the fiber tip in 1 patient.

Endometrial antibodies in serum and peritoneal fluid of infertile patients with and without endometriosis.

Passive hemagglutination assay was used to evaluate endometrial antibodies in serum and peritoneal fluid of 37 patients with endometriosis and 54 patients without endometriosis. The results showed that the concentration of antibody titers in serum and peritoneal fluid was significantly higher for endometriosis than control patients. The severity of endometriosis has no effect on antibody concentration. Furthermore, the concentration of endometrial antibody titers was significantly higher in serum than peritoneal fluid of patients with endometriosis. These results suggest that serum endometrial antibody assay is specific and valuable for the diagnosis and progress of endometriosis.

A potassium thiocyanate extract vaccine prepared from Pasteurella multocida 3:A protects rabbits against homologous challenge.

Potassium thiocyanate extracts of a virulent Pasteurella multocida 3:A rabbit isolate were prepared and used as a vaccine in rabbits. The extract contained protein, carbohydrate, hyaluronic acid, lipopolysaccharide, DNA, and RNA. The protein and lipopolysaccharide profiles of the extract were similar to those of the P. multocida cell membrane. Rabbits were vaccinated intranasally (i.n.) or intramuscularly (i.m.) four times at 1- or 3-week intervals and challenged i.n. with the homologous P. multocida 2 weeks after the last vaccination. Rabbits vaccinated with the extract by the i.n. route developed persisting serum immunoglobulin G (IgG) and nasal IgA antibodies, whereas rabbits immunized by the i.m. route produced persisting serum IgG and transient nasal IgA antibodies. The extract prevents the death of rabbits which were vaccinated by either route and challenged. Vaccination by the i.n. route in rabbits reduced the numbers of virulent P. multocida in nasal cavities and lungs and the prevalence and severity of rhinitis and pneumonia. These i.n.-vaccinated rabbits were also resistant to virulent P. multocida colonization in liver, spleen, uterus, and tympanic bullae. Similarly, i.m. vaccination in rabbits resulted in a reduction in the severity of rhinitis; the numbers of virulent P. multocida in lungs; and the prevalence of colonization in liver, spleen, uterus, and tympanic bullae. Vaccination by the i.n. route was superior to that by the i.m. route in that there was a significant reduction in the severity of pneumonia and numbers of virulent P. multocida in nasal cavities and lungs. Rabbits vaccinated with the extract without challenge showed no lesions.

Comparison of Chalquest and Hayflick media, with and without ammonium reineckate, for isolating Mycoplasma pulmonis from rats.

Chalquest and Hayflick media with and without ammonium reineckate were compared for isolation of Mycoplasma pulmonis from the nasopharyngeal ducts, tracheobronchial trees, and middle ears of 66 naturally infected rats. The results show that 92% (366 of 396) of the samples were positive for M. pulmonis in Chalquest medium with and without ammonium reineckate and 66% (260 of 396) were positive in Hayflick medium with and without ammonium reineckate (P less than 0.001). An enhancing effect of ammonium reineckate on M. pulmonis isolation was observed only in Hayflick medium; the isolation rate was 76% (151 of 198) in Hayflick medium with ammonium reineckate as compared with 55% (109 of 198) in Hayflick medium without ammonium reineckate (P less than 0.03). No significant differences in isolation rates were observed between Chalquest medium with and without ammonium reineckate. The mean growth time of M. pulmonis on Chalquest medium was 3.4 days as compared with 5.1 days in Hayflick medium, indicating that M. pulmonis can be detected earlier on Chalquest medium than on Hayflick medium. These data indicate that Chalquest medium is superior to Hayflick medium for M. pulmonis isolation from rats.

Capsular and somatic serotypes of Pasteurella multocida isolates recovered from healthy and diseased rabbits in Texas.

A total of 111 Pasteurella multocida isolates recovered from healthy and diseased rabbits were typed for capsular and somatic antigens by the typing systems of Carter and Heddleston, respectively. The major serotypes of the 48 P. multocida isolates recovered from nasal cavities of healthy rabbits were serotypes 12:A (33%), nontypable:A (50%), and nontypable:D (10%). Similarly, the major serotypes of the 63 P. multocida isolates obtained from rabbits with rhinitis, pneumonia, conjunctivitis, tympanitis, or cutaneous abscesses were serotypes 12:A (32%), nontypable:A (30%), and 3:A (16%). Serotype 12:A was predominant, regardless of whether the isolates were recovered from healthy or diseased rabbits.

Distribution of family practitioners and other specialists in Texas, 1973 to 1980: second statistical review.

A follow-up study was conducted at The University of Texas Southwestern Medical School at Dallas to document the changes in the geographic distribution of family/general practitioners and other medical specialists in Texas between 1973 and 1980. Results of the analysis suggest that more physicians are choosing to locate in sparsely populated areas of the state. This trend is a reversal of the pattern established in an earlier study and seems to indicate an improvement in the access to medical care for residents of small communities in Texas.

Two techniques to improve adherence to dietary sodium restriction in the treatment of hypertension.

To improve adherence to dietary sodium restriction, we validated two simple techniques for providing rapid and accurate estimated of urinary content-overnight urine collections and an immediate analysis of urine sodium content. These techniques were then applied in a trial with a group of patients with hypertension who were considered to be resistant to the adoption of dietary changes. After six months, 68% of the patients on the lower-sodium diet reduced their urine sodium content by one third or more. They had an 11-mm Hg fall in mean BP compared with a 3-mm Hg rise in the control group, who were not on a lower-sodium diet, and a lesser fall in plasma potassium levels.

Impact of a family practice residency program on physician location in small communities.

We conducted a study to determine the practice location pattern among graduates of a family practice residency program with respect to the distribution of the physicians in nonurban areas of the country. One of the primary goals of The University of Texas Southwestern Medical School at Dallas Family Practice Residency Program based in the John Peter Smith Hospital of Fort Worth is to encourage and increase the number of physicians who will eventually locate in rural areas or in small communities. Analysis of the project supports the conclusion that a residency training program does not need to be based geographically in a rural area to achieve an equitable distribution of physicians in nonurban areas.

Selection of primary care as a medical career: demographic and psychosocial correlates.

A study analyzing demographic and psychosocial correlates associated with the selection of primary care as a medical career was conducted on 357 physicians who were graduated from medical school between 1963 and 1966. Results suggest that individuals who were reared in smaller communities, who were among the younger siblings of their family, and who exhibited a strong pattern of socialization at home and school tended to choose a primary care specialty. The findings also suggest that if all other factors are equal and if production of primary care physicians is an important goal, medical school admission committees might consider including cross-validated psychosocial and demographic variables in selecting applicants to medical schools.

Hospitals and medical schools as factors in the selection of location of practice.

A study analyzing the relationship between the state in which a physician practices and the location of residency training was conducted using as subjects 467 individuals who entered graduate medical training programs at the University of Texas Southwestern Medical School at Dallas. The study population included physicians who were graduated from medical schools between 1955 and 1969 and who entered a phase of graduate training (internship/residency) at one of Southwestern Medical School's affiliated teaching hospitals. Results of the study support the conclusions of an earlier report that stressed the influence of the location of residency training in retaining physicians in Texas. The statistical findings indicate that if all other factors are equal, additional residency positions filled by graduates of medical schools in the same state might aid in increasing the retention rate of medical practitioners there.