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The ability of fluorophotometry to measure the time course of changes in aqueous humor flow in rabbits was evaluated by measuring the effect of intravenous carbonic anhydrase inhibitors on aqueous humor flow determinations. The abrupt changes in aqueous humor flow which were found by fluorophotometry agreed well with the expected changes in aqueous humor flow calculated from the time course of the intraocular pressure. Therefore, it was concluded that fluorophotometry could measure the time course of changes in aqueous humor flow in rabbits. Furthermore, it was suggested that the initial abrupt changes in aqueous humor flow after the administration of a carbonic anhydrase inhibitor were induced by the base content of the drug, followed by a more gradual decrease in aqueous humor flow caused by the direct effect of the drug on aqueous humor formation.

1. Hyperacute rejections occurred in 0.6% of 19,415 first cadaver donor grafts and 1.9% of 4,326 regrafts. When grouped into those without preformed cytotoxins, 0.5% first grafts and 1.3% of regrafts had hyperacute rejection. Among patients with cytotoxins 1.3% of first grafts and 2.6% of regrafts had hyperacute rejections. 2. A total of 923 first cadaver donor transplants and 238 multiple transplants were crossmatched by 6 variations of microcytotoxicity tests: standard, long 4-hour incubation, B lymphocytes at 4 degrees C and 37 degrees C and T lymphocytes at 4 degrees C and 37 degrees C. All crossmatching was done in one laboratory. 3. For first cadaver donor transplants, 178 patients with long positive crossmatches and 56 patients with T warm positive crossmatches had a significantly lower survival rate than crossmatch negative patients. Those with short positive (weak), B warm, B cold, and T cold positive crossmatches had the same graft survival as crossmatch negative patients. 4. In regrafted patients from cadaver donors those with a short and T warm positive crossmatches had lower graft survival than crossmatch negative patients. 5. Preformed T warm cytotoxins were associated with lower graft survival in first grafts and B warm cytotoxins were associated with lower graft survival in regrafts. 6. Eight patients with T warm positive crossmatches were successfully transplanted (function at 3 months) after they were shown to have IgM antibodies removable by 2-ME treatment. 7. A total of 136 patients were tested by FCXM at the time of transplant on a retrospective basis. Although all patients were crossmatch negative by the T warm tests, 24 were FCXM positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Renal emphysema is rare condition that may affect diabetic patients. Radiographic demonstration of gas limited to the collecting system is often treated with antibiotics. However, intraparenchymal gas requires early nephrectomy because mortality rates are high without surgical intervention.

The effects of high CO2 concentration on tissue staining with buffered eosin, methylene blue and azure A were investigated to determine if carbamino compound formation could alter dye binding. Only in the case of eosin staining were the differences in results with high and low CO2 concentrations compatible with the formation of carbamino compounds. The differences observed with basic dyes were statistically significant but could not be accounted for by carbamino compound formation.

The major histocompatibility complex (MHC) encodes cell surface glycoproteins that function in self-nonself recognition and in allograft rejection. Among primates, the MHC has been well defined only in the human; in the chimpanzee and in two species of macaque monkeys the MHC is less well characterized. Serologic, biochemical and genetic evidence indicates that the basic organization of the MHC linkage group has been phylogenetically conserved. However, the number of genes and their linear relationship on the chromosomes differ between species. Class I MHC loci encode molecules that are the most polymorphic genes known. These molecules are ubiquitous in their tissue distribution and typically are recognized together with nominal antigens by cytotoxic lymphocytes. Class II MHC loci constitute a smaller family of serotypes serving as restricting elements for regulatory T lymphocytes. The distribution of class II antigens is limited mainly to cell types serving immune functions, and their expression is subject to up and down modulation. Class III loci code for components C2, C4 and Factor B (Bf) of the complement system. Interspecies differences in the extent of polymorphism occur, but the significance of this finding in relation to fitness and natural selection is unclear. Detailed information on the structure and regulation of MHC gene expression will be required to understand fully the biologic role of the MHC and the evolutionary relationships between species. Meanwhile, MHC testing has numerous applications to biomedical research, especially in preclinical tissue and organ transplantation studies, the study of disease mechanisms, parentage determination and breeding colony management. In this review, the current status of MHC definition in nonhuman primates will be summarized. Special emphasis is placed on the CyLA system of M. fascicularis which is a major focus in our laboratory. A highly polymorphic cynomolgus MHC has been partially characterized and consists of at least 14 A locus, 11 B locus, 7 C locus class I allelic specificities, 9 Ia-like class II antigens and 6 Bf (class III) variants.

The gastric emptying of a mixed solid and liquid meal was assessed in 24 normal subjects using a single camera/computer system which allowed continuous monitoring of both solids and liquids. It was shown that variation in tissue attenuation caused by the changing depth of radionuclide within the stomach accounted for large errors in the measurement of gastric emptying (alteration in 50% emptying time of up to 65%). A technique for the correction of attenuation is described which used factors derived from a lateral image of the stomach. In all subjects, solid emptying was slower than liquid emptying and was characterised by a delay (lag period) which was followed by linear emptying. Liquid emptying usually followed a single exponential pattern. The effect of physiological changes induced by increasing the calorie content of the liquid component of the meal was assessed by giving either water, 10% dextrose or 25% dextrose. Liquid emptying was slowed and the lag period of solid was prolonged as the calorie content increased. Reproducibility was assessed in 19 subjects. For the three groups studied (water, 10% dextrose, 25% dextrose) the day-to-day variation in gastric emptying was not significant for any measured parameter, while statistically significant differences were present in solid and liquid emptying between subjects and groups.

A 57-year-old woman underwent pulmonic valvotomy for congenital pulmonic stenosis. She developed severe pulmonic insufficiency, secondary tricuspid regurgitation, and anasarca in spite of a normal pulmonary artery pressure. Insertion of a pulmonary valve prosthesis and tricuspid valve plication reversed all clinical symptoms and signs of this rare complication of pulmonary valvotomy.

The addition of ionic calcium to technetium-99m stannous phytate produced an agent with improved splenic uptake. In a series of patients, it was found that molar ratios of 2:1 and 3:1 produced scans of optimal diagnostic quality. Studies in mice showed dose-related changes in the biodistribution. Electron microscopy demonstrated that the addition of calcium produced progressive aggregation of the colloid as the molar ratio was increased. Chemical analysis of sodium phytate was essential to obtain accurate ratios.

1. Positive FCXM reactions were associated with sensitization in transplants with negative cytotoxic crossmatches. Recipients of regrafts, females, particularly those with previous pregnancies, and recipients with historical cytotoxic antibody reactivity were more likely to have FCXM detectable antibodies. 2. Primary nonfunction grafts were associated with a positive FCXM, but predominantly in those transplants involving female, older, or nontrauma donors. Nearly 40% of the FCXM positive transplants of these organs did not function during the first month posttransplant 3. Low 3-month graft survival rates were associated with a positive FCXM reaction, but once again this was seen with female, older, and nontrauma donor transplants. In addition, approximately 40% of FCXM positive transplants involving older or nontrauma donors that did survive had poor graft function at 3 months.

More than most diseases, acquired immune deficiency syndrome (AIDS) appears to elicit highly negative, fearful, and prejudicial attitudes. In the study reported here, medical students read one of four patient vignettes. The vignettes were identical in content except that the patient was identified as having either AIDS or leukemia as either homosexual or heterosexual. The students then completed a set of objective measures that assessed their attitudes toward the patient portrayed in the vignette. Multivariate and univariate analyses of variance of their responses revealed that the students held negative and prejudiced attitudes toward both the AIDS and homosexual patients. This finding suggests that medical educators should recognize that many students have stigmatizing, negative attitudes toward homosexuals and patients with AIDS. These educators should promote greater sensitivity, knowledge, and understanding among medical students of those at risk for AIDS and AIDS patients.

A 69-year-old woman presenting with dyspnea had a pericardial window created for fibrinous pericarditis. The patient subsequently developed pulmonary hypertension and a ventilation perfusion scan was compatible with pulmonary thromboembolism. A primary tumour of the pulmonary artery was suggested by angiography, computerized axial tomography and magnetic resonance imaging. Pathology confirmed a spindle cell pulmonary artery sarcoma.

Fluorophotometry and tonography were used before and after argon laser trabeculoplasty to measure aqueous humor dynamics in 15 eyes of 14 patients. A new fluorophotometric method used to measure true outflow facility showed that it increased from a mean pretreatment value of 0.016 microliter/min/mm Hg to a mean posttreatment value of 0.075 microliter/min/mm Hg. Similarly, total outflow facility, measured tonographically, increased from 0.112 microliter/min/mm Hg to 0.151 microliter/min/mm Hg. Uveoscleral flow decreased after laser therapy; however, this was secondary to the decrease in intraocular pressure. No effect was found on the rate of aqueous humor production. We concluded that the primary effect of argon laser trabeculoplasty was to increase true outflow facility, thereby decreasing intraocular pressure.