Recovery of patients after four months or more in the persistent vegetative state.

A retrospective review was made of the case notes of 43 consecutive patients admitted to a unit specialising in the rehabilitation of people in the persistent vegetative state. Eleven of these patients regained awareness four months or more after suffering brain damage. The time to the first reported incidence of eye tracking was between four months and three years, and the time to the first response to command was between four and 12 months. Only one patient was eventually unable to communicate, six could use non-verbal methods of indicating at least a yes or no response, and four were able to speak. Six patients remained totally dependent while two became independent in daily activities. Four patients became independent in feeding, three required help, and four remained on gastrostomy feeding. Thus some patients can regain awareness after more than four months in a vegetative state, and, although few reach full independence, most can achieve an improved quality of life within the limitations of their disabilities. The recovery period is prolonged and may continue for several years. Even patients with profound brain damage should be offered the opportunity of a specialist rehabilitation programme.     

Secretion of ceruloplasmin by a human clear cell carcinoma maintained in nude mice

Ceruloplasmin is the best known but least understood copper protein. Studies preliminary to investigating the control of ceruloplasmin synthesis have utilized a human renal cell carcinoma maintained in nude mice for 73 passages over a 5-year period. In vitro cultures of these cells were accomplished and the mRNAs were extracted prior to microinjection into Xenopus oocytes. The media examined by SE-HPLC and immunological techniques demonstrated that (1) after in vitro culture, ceruloplasmin was secreted as an uncleaved polypeptide chain with a MW of 135,000; (2) the translational product of ceruloplasmin mRNA injected into Xenopus oocytes was cleaved into fragments with MWs of 110,000, 67,000, and 50,000. The results indicate that mRNA for human ceruloplasmin can be obtained to serve as a template for the synthesis of a cDNA probe to investigate the control of human ceruloplasmin's synthesis.     

Vitamin C Supplementation in the Elderly: A 17-month Trial in an Old Persons' Home

Seventeen months'' supplementation of the diet with vitamin C in elderly residents in an old persons'' home failed to show any changes in sublingual lesions, which on histological examination proved to be aneurysmal dilatations of the venules. Nine months'' supplementation of 40 to 80 mg. daily of vitamin C was necessary before the white-cell vitamin levels reached that found in younger people. There was a marked individual variation in response.     

Ammonium 4-chloro-7-sulfobenzofurazan: a new fluorigenic thiol-specific reagent

This paper describes the synthesis and study of a new fluorigenic, thiol-specific reagent, ammonium 4-chloro-7-sulfobenzofurazan, which is readily prepared by sulfonation of 4-chlorobenzofurazan. Evaluation of ammonium 4-chloro-7-sulfobenzofurazan was undertaken using glutathione as a model thiol peptide and bovine serum albumin and jackbean urease as thiol-containing proteins. Thiol specificity of this reagent was established using various amino acids and peptides including l-cysteine, l-lysine, l-histidine, l-tyrosine, glutathione, and oxidized glutathione. Nitrogen and sulfur derivatives of ethanediol and acetic acid were also investigated. Optimum conditions for the thiol labeling reaction have been investigated using the parameters of pH, buffer type, time, temperature, and relative concentrations. Under appropriate conditions the fluorescence produced by the reaction of ammonium 4-chloro-7-sulfobenzofurazan is linearly related to thiol concentration. The fluorescence intensity of 7-sulfobenzofurazan thiol derivatives are considerably greater than the corresponding 7-nitrobenzofurazan derivatives in both aqueous and aprotic solvents, rendering this reagent highly sensitive. Our preliminary experiments with proteins labeled with ammonium 4-chloro-7-sulfobenzofurazan have shown the probe to be removable by thiolysis with excess 2-mercaptoethanol.     

Screening for Inherited Metabolic Disease by Plasma Chromatography (Scriver) in a Large City

Before introducing a more comprehensive screen such as plasma chromatography, with its potential to detect 20 amino-acid disorders—an advantage over screening methods which detect only phenylketonuria—the greatly increased problems of organization and the effect on the community, midwives, paediatric services, and laboratory should be considered. The three years'' experience in Birmingham showed a three-fold increase in cases detected and suggests criteria for further investigation and treatment.