An influenza A (H1N1) virus, closely related to swine influenza virus, responsible for a fatal case of human influenza.

In July 1991, an influenza A virus, designated A/Maryland/12/91 (A/MD), was isolated from the bronchial secretions of a 27-year-old animal caretaker. He had been admitted to the hospital with bilateral pneumonia and died of acute respiratory distress syndrome 13 days later. Antigenic analyses with postinfection ferret antisera and monoclonal antibodies to recent H1 swine hemagglutinins indicated that the hemagglutinin of this virus was antigenically related to, but distinguishable from, those of other influenza A (H1N1) viruses currently circulating in swine. Oligonucleotide mapping of total viral RNAs revealed differences between A/MD and other contemporary swine viruses. However, partial sequencing of each RNA segment of A/MD demonstrated that all segments were related to those of currently circulating swine viruses. Sequence analysis of the entire hemagglutinin, nucleoprotein, and matrix genes of A/MD revealed a high level of identity with other contemporary swine viruses. Our studies on A/MD emphasize that H1N1 viruses in pigs obviously continue to cross species barriers and infect humans.     

The reuse of hemodialyzers: an assessment of safety and potential savings.

OBJECTIVE: To evaluate the safety and potential cost savings of hemodialyzer reuse. DATA SOURCES: All English and French articles published from 1960 to 1991 related to hemodialyzer reuse (retrieved through an Index Medicus and MEDLINE search [corrected]), the indexes of eight North American journals from 1960 onward, conference proceedings, association guidelines, and US and Canadian laws and regulations. RESULTS: For health care personnel the reuse of hemodialyzers did not entail any increased risk of infection or exposure to toxic substances if proper control measures were taken. For patients there was no evidence to suggest any excess risk of complications or death as long as precise and appropriate procedures are observed. The "first-use syndrome" can be prevented and should no longer be considered as a reason to favour reuse. A cost-minimization analysis indicated that five uses might save up to $3629 per patient yearly. Thus, the adoption of a policy of reuse in Canada for all eligible patients undergoing long-term hemodialysis could result in direct savings of about $5.8 to $8.9 million per year. CONCLUSION: The health risks associated with hemodialyzer reuse can be reduced to acceptable levels through the rigorous observance of proper quality-assurance and quality-control measures and the use of automated reconditioning equipment. Such a policy could achieve modest savings for the health care system. A decision to reuse should be formally adopted by the institution and accompanied by a precise definition of the standards of quality assurance and control.     

Plant preference in relation to life history traits in the zoophytophagous predator Dicyphus hesperus

Dicyphus hesperus Knight (Heteroptera: Miridae) is an omnivorous predator used to control pests of greenhouse vegetables. Plant preferences and life history traits were studied using nine plant species: Lycopersicon esculentum Mill. (Solanaceae), Capsicum annuum L. (Solanaceae), Verbascum thapsus L. (Scrophulariaceae), Nepeta cataria L. (Lamiaceae), Stachys albotomentosa (Lamiaceae), Nicotiana tabacum L. (Solanaceae), Vicia sativa L. (Fabaceae), Zea mays L. (Gramineae), and Chrysanthemum coronarium L. (Asteraceae). Plants were selected from among potential target crops, natural hosts, plants used for mass rearing, and plants on which D. hesperus has not been reported. Plant preference was measured by multi‐choice host plant selection and oviposition assays. Development and reproduction were measured on each of the plant species on both a plant diet alone and on a plant diet supplemented with Ephestia kuehniella Zeller (Lepidoptera: Pyralidae) eggs. Dicyphus hesperus females and nymphs expressed a preference for some plants over others. Plant preference ranged from low preference plants, such as Z. mays, V. sativa, C. coronarium, and C. annuum, to high preference plants such as V. thapsus, N. tabacum, and S. albotomentosa. When E. kuehniella eggs were supplied, there were few differences in the development time and fecundity of D. hesperus among plants, with the exception of corn and broad bean, where fecundity was lower. On a plant diet alone, nymphs were able to complete their development on V. thapsus, C. annuum, and N. cataria. However, mortality and development time were much lower on V. thapsus than on C. annuum and N. cataria. On most of the plant species D. hesperus did not lay any eggs when fed on a plant diet alone. On V. thapsus, females laid a few eggs and lived longer than when fed on prey. Dicyphus hesperus females tended to prefer host plants on which nymph survival without prey was greatest.     

How has extracorporeal shock-wave lithotripsy changed the treatment of urinary stones in Quebec?

OBJECTIVES: To determine the number of people who underwent treatment of urinary stones in Quebec before and after the introduction of extracorporeal shock-wave lithotripsy (ESWL) and to determine how the introduction of ESWL influenced resource utilization. DESIGN: Before-after study; data were obtained from administrative databases and hospital-based cost estimates. SETTING: The 68 acute care hospitals in Quebec in which treatment of urinary stones is undertaken. PATIENTS: Quebec residents admitted to hospital for treatment of urinary stones between the fiscal years 1984 and 1992. OUTCOME MEASURES: Number of people treated for urinary stones per year, total number of procedures per year (including open surgery, percutaneous procedures, retrograde procedures and ESWL), and annual resources (including number of hospital bed-days and direct costs) for treatment of urinary stones used overall and in hospitals with and without ESWL services. RESULTS: Over the study period the number of people treated for urinary stones increased by 59%. As well, the combined frequency of ESWL and surgery (the two main treatment methods) increased by 107%. These increases were largely due to rates of treatment that grew by 52% among women and by 34% among men. The total number of hospital bed-days decreased by 28%, which reflected shorter hospital stays for ESWL. However, despite this decrease, the total direct annual costs were 7% higher in 1992 than in 1984 because of the increased numbers of people treated and procedures performed. In the three hospitals that offered ESWL the number of hospital bed-days and the direct costs of treating urinary stones increased by 49% and $2.5 million respectively. In the 65 other hospitals these figures decreased by 41% and about $2.9 million respectively. CONCLUSIONS: Because of increased intervention rates the total cost of treating urinary stones has risen since the introduction of ESWL. The introduction of ESWL has also been associated with a shift in the use of resources for treating urinary stones to hospitals with a lithotriptor. The reasons for the increased intervention rates are unknown. However, given the possibility of negative health effects and the increased costs, studies to determine whether the increased rates improve health outcomes are warranted.     

The influence of glycyl residues on the flexibility of peptide hormones in solution. A 13C-nuclear-magnetic-resonance study of luteinizing hormone-releasing hormone (luliberin) and its des-glycinamide10 N-ethylamide analog.

13C nuclear magnetic resonance spectroscopy in used to gain information on the flexibility of the backbone in peptide hormones and peptide hormone analogs. 13C spin-lattice relaxation times (T1) were measured on luliberin, the luteinizing-hormone-releasing hormone and des(Gly-NH2)10-luliberin-N-ethylamide in aqueous solution at 25.2 and 67.9 MHz at temperatures of 32 degrees, 40 degrees and 55 degrees C. The 13C spin-lattice relaxation times indicate increased flexibility of the peptide backbone in the immediate environment of glycyl residues in luliberin (less than Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2) and the hormone analog des(Gly-NH2)10-luliberin-N-ethylamide (less than Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-NH-CH2CH3) in aqueous solutions. 13 C NMR spectroscopy is shown to be a sensitive technique for monitoring the time-averaged conformational flexibility of peptides in solution. Activation energies (Ea) of about 25 kJ/mol were obtained for rotational reorientation of non-terminal alpha-carbons in the peptide backbone. Rotation of methyl groups was characterized by an Ea of 9.6 kJ/mol whereas reorientation of the N-terminal pyroglutamyl residue showed an Ea value of 14.6 kJ/mol. The Ea values of individual carbons in the side-chains of prolyl, arginyl and leucyl residues in the peptides were similar to those obtained for the alpha-carbon of the same amino acid residue in the peptide backbone of the hormones.     

Characterization of human blood platelet membrane proteins and glycoproteins by their isoelectric point (pI) and apparent molecular weight using two-dimensional electrophoresis and surface-labelling techniques

Intact human blood platelets were radioactively labelled at the surface by techniques specific for proteins or glycoproteins. Labelled platelet samples were analyzed by a high-resolution two-dimensional separation system involving isoelectric focusing in the first dimension and discontinuous sodium dodecyl sulphate-polyacrylamide gel electrophoresis in the second. The major platelet membrane glycoprotein (GP) bands (Ib, IIb, IIIa and IIIb) were found to be highly heterogeneous even after removal of terminal sialic acid residues. Lactoperoxidase-catalyzed iodination of platelets showed that the major labelled proteins (Ib, IIb, IIIa and IIIb) had altered isoelectric points ($\text{p}\text{I}$) and molecular weights after neuraminidase treatment. A number of membrane glycoproteins previously undetected by one-dimensional gel electrophoresis were demonstrated and good evidence provided that the major platelet surface proteins are glycosylated.     

The role of transferrin and citrate in cellular uptake of aluminium

Summary The ability of human erythroleukaemia K562 cells to take up aluminium from Al-transferrin and Al-citrate has been examined. Uptake from Al-transferrin was dose-dependent over the range 68–544 ng/ml of aluminium, and increased over a 12-day period. In contrast, uptake from Al-citrate was low even at an aluminium concentration of 6800 ng/ml and did not increase over time. Neither form of aluminium greatly affected cell growth. It is concluded that Al-transferrin, rather than Al-citrate, is the physiologically relevant form of this metal with respect to cellular uptake, but that any metabolic abnormalities induced by aluminium do not affect proliferation of this cell line.