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The pathogenesis of inflammatory periodontal disease was studied by examining the mechanism of HeLa and HL60 cell growth inhibition by cell-free saline-soluble extracts of Eikenella corrodens and bacterial plaque. Previous studies identified a protein (p80) as causing growth inhibition by E. corrodens extracts. After purification by two-dimensional SDS-PAGE, p80 was digested with protease lysC. Amino acid sequences were obtained and backtranslated for use as PCR primers. A 5840 nucleotide sequence containing a lysine decarboxylase gene was obtained from a Sau3 A1 genomic library of E. corrodens DNA. Lysine decarboxylase activity was present at physiologic pH in the E. corrodens extracts containing p80, and also in bacterial plaque. Both extracts caused growth inhibition by depleting lysine from cell culture media through conversion to cadaverine. Adding lysine, or immune goat IgG to a peptide derived from the active site sequence of E. corrodens lysine decarboxylase, retarded lysine depletion and growth inhibition. epsilon-Amino caproic acid specifically enhanced lysine decarboxylase activity at the low lysine concentration in HL60 cell culture media, and also increased the growth inhibition. Thus, lysine decarboxylases such as p80 inhibit growth by removing lysine from mammalian cell culture media. A new role for lysine decarboxylase activity in the microbial aetiology of periodontal disease is discussed., (Copyright 2001 Academic Press.)

This paper reviews maternal mortality in Kentucky over the 30 year period of 1966 through 1995. Data were reviewed from the minutes of the State Maternal Mortality Study Committee and the reports of the State Cabinet of Health Services, State Centers for Health Statistics. There has been a marked fall in the number of births during this 30 years and an even more dramatic reduction in maternal mortality. Identifiable causes for maternal death have changed over the years. Today, the three leading causes of maternal mortality in Kentucky mirror those of the nation, i.e., hemorrhage, pulmonary embolus, and toxemia.

We present the case of a 33-year-old white male truck driver with a ten-year history of 3.5-g/wk "crank" and "peanut butter methamphetamine" inhalation (methamphetamine and propylhexedrine, respectively). This patient developed marked pulmonary hypertension as a probable consequence of abuse of these drugs. Proposed mechanisms of disease invoke toxic endothelial injury, hypoxic insult, direct spasm, vasculitis, and dysregulation of mediators of vascular tone. The possible role of genetics is discussed in reference to variability of human response to sympathomimetic challenge.

CA 125 is an antigenic determinant located on the surface of ovarian carcinoma cells and elevated in the serum of greater than 90% of patients with carcinoma. The antigen, derived from the ovarian epithelium, has been described as a mucinlike glycoprotein greater than 200 kd. To date little is known of the metabolic regulation or expression of this antigen in either normal or neoplastic tissues. New monoclonal antibodies that we describe here recognize both unique and similar epitopes to OC 125. These reagents may allow for a more complete definition of the structure and expression of the CA 125 complex. These antibodies recognize high-molecular weight (greater than 200 kd) subspecies and a lower-molecular-weight (68 kd) subspecies of the antigen and identify it in the cytoplasm and the extracellular matrix of CA 125-producing cells.

The influence of preeclampsia on the circulating concentrations of the 28-amino-acid carboxy terminus (C-terminus) (i.e., atrial natriuretic factor) and the amino terminus (N-terminus) of the 126-amino-acid atrial natriuretic factor prohormone (pro ANF) was studied in the third trimester with the use of three specific radioimmunoassays that recognize: (1) atrial natriuretic factor (i.e., amino acids 99 to 126), (2) the whole 98-amino-acid N-terminus, and (3) amino acids 31 to 67 from the midportion of the N-terminus of the prohormone. The C-terminus was significantly increased (p less than 0.001) in the third trimester in women with preeclampsia, the mean +/- SEM of 15 subjects was 150 +/- 7 pg/ml versus 89 +/- 7 pg/ml in the third trimester in 12 women during normal pregnancies and 65 +/- 2 pg/ml in 19 healthy nonpregnant women. The whole 98-amino-acid N-terminus, likewise, was significantly increased (p less than 0.001) in women with preeclampsia to 4706 +/- 629 pg/ml versus 2160 +/- 79 pg/ml in women in the third trimester of normal pregnancies and versus the circulating concentration of 1847 +/- 127 pg/ml in healthy nonpregnant women. ProANF 31 to 67 mean circulating concentration in preeclampsia was 4638 +/- 725 pg/ml, which was also significantly (p less than 0.001) increased compared with its mean circulating concentration in the third trimester of normal pregnancy of 1758 +/- 83 pg/ml or that in healthy nonpregnant women (1400 +/- 105 pg/ml). The circulating concentrations of both the N-terminus and C-terminus of the atrial natriuretic factor prohormone decreased within 24 hours after delivery in contrast to a normal pregnancy in which they both increase post partum. These results indicate a marked difference in the metabolism of both the N-terminus and the C-terminus of the atrial natriuretic factor prohormone in women with preeclampsia versus that in women with normal pregnancies or that in healthy nonpregnant women.

New murine monoclonal antibodies to a partially purified CA 125 antigen were developed and identified as M 2 and M 11. With immunohistochemical techniques, these new antibodies and OC 125 antibody were used to search for CA 125 in embryonic tissues and adult apocrine sweat glands and mammary glands. The embryonic skin, the periderm, expressed CA 125 antigen and its adult derivatives, the mammary glands and apocrine sweat glands, expressed CA 125 while in the active state of secretion. In a 6-week-old formalin-fixed and paraffin-embedded ectopic embryo specimen, antibodies M 2 and M 11 recognized CA 125 in the periderm, the notochord, the myocardium, the pericardium, the gastroenteric tract, enteric duct remnants in the umbilical cord (vitelline and allantoic ducts), the mesonephric duct, and the amnion. OC 125 staining of these formalin-fixed specimens was either very faint or absent. In a formalin-fixed and paraffin-embedded specimen of apocrine sweat glands from the axilla, antibodies M 2 and M 11 detected CA 125 antigen intracellularly in the secretory cells. Again no staining was observed with OC 125 antibody. In a frozen and acetone-fixed specimen of lactating mammary glands, antibodies M 2 and OC 125 detected CA 125 antigen intraductally. Colostrum and milk collected from 25 mothers at various stages post partum had mean CA 125 levels of 34,213 U/ml in colostrum, 1469 U/ml at 3 to 7 days, and 105 U/ml at 5 to 26 weeks.

Oxygen saturation and end-tidal CO2 tension were monitored in 15 healthy women during labor. Oxygen saturation was determined with a pulse oximeter and end-tidal CO2 with a CO2 monitor. Fetal heart rate, uterine contractions and maternal blood pressure were also monitored. End-tidal CO2 tension was followed to determine if falls in oxygen saturation during labor were related to hyperventilation. Ten of the 15 patients exhibited periods of oxygen saturation of less than 90%. End-tidal CO2 was consistently low, usually less than 30 mm Hg. Most, but not all (7 of 10), of the patients who showed desaturation had received narcotics. There were often periods of apnea and/or shallow respirations between contractions. These aberrations and hyperventilation-induced hypocarbia were probably the cause of the oxygen desaturation. No changes in fetal heart rate or low Apgar scores were noted.

The influence of pregnancy on the circulating concentrations of atrial natriuretic factor, the 28 amino acid carboxy (C)-terminal end of the 126 amino acid atrial natriuretic factor prohormone, and the amino (N)-terminus of the prohormone was studied with three specific radioimmunoassays recognizing: (1) atrial natriuretic factor (i.e., amino acids 99 through 126), (2) the 98 amino acid N-terminus, and (3) amino acids 31 through 67 from the midportion of the N-terminus of the prohormone. Plasma atrial natriuretic factor in normal pregnant women gradually increased as pregnancy progressed, with the mean +/- SEM being 58 +/- 4 pg/ml in the first trimester, 74 +/- 5 pg/ml in the second trimester, and 89 +/- 7 pg/ml in the third trimester. Likewise, proatrial natriuretic factor 31 through 67 increased from 1421 +/- 76 pg/ml (first trimester) to 1509 +/- 84 pg/ml (second trimester) to 1758 +/- 83 pg/ml in the third trimester, whereas the whole N-terminus of the prohormone increased from 1804 +/- 98 pg/ml (first trimester) to 1909 +/- 111 pg/ml (second trimester) to 2160 +/- 79 pg/ml in the third trimester. These results suggest that release of the N-terminus of the prohormone, as well as atrial natriuretic factor, increases with the rise in blood volume associated with a normal pregnancy. The circulating concentrations of both the C-terminus and N-terminus of the atrial natriuretic factor prohormone increased further in the 48 hours after delivery. Because both the C-terminus and N-terminus of the atrial natriuretic factor prohormone contain diuresis-producing peptides, these results suggest that postpartum diuresis may be mediated by these peptides.

Alphaprodine is a synthetic narcotic, structurally similar to meperidine. Respiratory depression has been reported as a not-infrequent side effect when larger doses of alphaprodine were used, particularly intravenously. In this study, the maternal respiratory rate and tissue pO2 and pCO2 were determined in patients receiving alphaprodine, 0.4 mg/kg of prepregnancy weight, for first-stage analgesia. Statistically significant falls in maternal tcpO2 and increases in tcpCO2 were observed. The baseline fetal heart rate decreased significantly 20 minutes after the injection (139 to 132 bpm). There was no increase in abnormal fetal heart rate patterns. The variability of the baseline fetal heart rate was unchanged until 25 minutes following alphaprodine administration, when a significant reduction occurred. The changes seen in the parameters monitored in this study were not associated with any clinically adverse effects on the mother or fetus.

The high incidence of pulmonary complications following evacuation of molar gestation at 16 weeks' size of greater (27%) prompted us to institute hemodynamic monitoring in seven of these patients in an effort to determine etiologies and possible modes of therapy for this potentially life-threatening complication. Our data indicate that following suction curettage with general anesthesia there appears to be impairment of ventricular performance of a transient nature as manifested by increases in central venous pressure, mean pulmonary artery pressure, and pulmonary capillary wedge pressure, despite a slight elevation in cardiac index and a decrease in systemic vascular resistance. The possible role of general anesthesia in the development of these changes, as well as the role of the colloid osmotic pressure to wedge gradient in the development of pulmonary complications, is discussed.

Water is a critical ecological factor in substrate dense matric ecosystems, of which composting systems are an example. Excessive moisture inhibits aerobic metabolism because of oxygen diffusion limitations. How a lack of water impedes composting activity has not been previously considered. An investigation of the relationship of matric water potential (water held by physical attractions) to gravimetric water content was carried out in a laboratory composting system using a sewage sludge and wood chip substrate. The gravimetric-matric water relationship was best fit by a 2∘ polynomial regression of y=64.049-0.142 x, andR= 0.95. It is proposed that the commonly observed failure of composting to occur under drier conditions is a physical limitation, that is bacteria progressively fail to physically colonize the substrate as matric potential decreases below approximately -20 kPa. In physically mixed systems, agitation and introduction of inoculum may promote colonization, permitting composting to be initiated and proceed at lower moisture contents. In nonmixed systems, promotion of thorough initial colonization may permit composting to continue in the presence of significant drying.

Fetal hiccups are commonly diagnosed during the antepartum period, and they have a tendency to recur. The reflex of hiccuping is similar to that of gasping, except hiccuping efforts are made against a closed airway. An episode of intrapartum hiccups was confirmed via real-time ultrasound scanning during monitoring with a direct fetal scalp electrode. A neonatal heart rate pattern during hiccuping is also included. Distinctive fetal and neonatal heart rate patterns were observed during the hiccuping episode. It is speculated that the fetal heart rate pattern seen with hiccups may resemble that of fetal gasping.