OBJECTIVETo determine whether hypertonic saline nasal spray relieves nasal symptoms and shortens illness duration in patients with the common cold or acute rhinosinusitis.DESIGNRandomized trial with 2 control groups.SETTINGTwo family practice clinics.PARTICIPANTSOne hundred forty-three adult patients with a cold or sinus infection. Patients with allergic rhinitis, symptoms for more than 3 weeks, or other respiratory diagnoses were excluded, as were those who had used topical decongestants.INTERVENTIONHypertonic saline or normal saline spray 3 times a day or observation. Subjects completed a 7-day symptom checklist that included a well-being question ("Do you feel back to normal?").MAIN OUTCOME MEASURESNasal symptom score (sum of scores for nasal congestion, rhinorrhea, and headache) on day 3 and day of well-being (day of symptom resolution).RESULTSData were collected for 119 subjects. No difference was found in either primary outcome when hypertonic saline was compared with either normal saline or observation. Mean day of well-being was 8.3 (95% confidence interval [CI], 6.9-9.7), 9.2 (95% CI, 6.9-11.43), and 8.0 (95% CI, 6.7-9.3) days in the hypertonic saline, normal saline, and observation groups, respectively. Day 3 mean nasal symptom score was 3.8 (95% CI, 3.0-4.5) for hypertonic saline, 3.7 (95% CI, 2.9-4.5) for normal saline, and 4.1 (95% CI, 3.5-4.7) for observation. Only 44% of the patients would use the hypertonic saline spray again. Thirty-two percent noted burning, compared with 13% of the normal saline group (P = .05).CONCLUSIONHypertonic saline does not improve nasal symptoms or illness duration in patients with the common cold or rhinosinusitis.

The problem of predicting mortality among rural elderly (65 years and older) living independently is examined using 20-year panel data derived from a random multistage cluster sample. Fifteen independent variables, including social networks, age, sex, and health status, were hypothesized on theoretical and empirical grounds to predict mortality. Face-to-face structured interviews were conducted with the same respondents in 1966, 1974, and 1986/87. Logistic regression establishes that a model comprising age, sex, participation in formal organizations, relative and children association, and general health status is a powerful predictor of mortality. The authors conclude that the more heterogeneous formal, or secondary, social networks which may enhance self esteem are most functional for the elderly.

Hatchery-reared parr and smolts of Atlantic salmon (Salmo salar) derived from spawners of the Big Salmon, Saint John, and Penobscot rivers were analyzed for activity of two respiratory chain enzymes in liver. Cytochrome c oxidase activity was about 15-fold greater in enzyme units than succinate dehydrogenase in all three experimental groups. Smolt sample means for cytochrome c oxidase and succinate dehydrogenase in Big Salmon and Saint John fish were significantly greater than those of parr. Measurements in Big Salmon fish, which had the greatest parr–smolt difference in cytochrome c oxidase units and condition factor, demonstrated a significantly greater smolt sample mean for liver mitochondria concentrations. The results are discussed primarily in relation to the possible role of thyroid hormone in causing a greater potential for aerobic energy generation in liver during smoltification and the utilization of lipid as an energy resource.

The finfish aquaculture industry of Maine is in a relative state of infancy, with production primarily of rainbow trout (Salmo gairdneri) and brook trout (Salvelinus fontinalis). Coho salmon (Oncorhynchus kisutch) were reared in floating pens in the early 1970's, but operations ceased. Today, there is a pilot program in the ocean ranching of Pacific salmon, and interest in pen-rearing of Atlantic salmon (Salmo salar), pen-fattening of bluefin tuna (Thynnus thynnus), and culture of American eels (Anguilla rostrata), rainbow smelt, and flatfishes. To increase finfish production by the aquaculture industry in Maine, several economic, social, and legislative problems must be overcome. But the result could be a significant increase in the state's economy, currently one of the poorest in the nation.

The use of mid-level practitioners (nurse practitioners, physician's assistants, and so on) is advocated to improve the access of rural people to health care. A remote rural area of southern Appalachia is served by a network of three clinics staffed by mid-level practitioners (MLPs) and an M.D. During the first three years of operation 76% of the geographically defined target population of 5,500 received services. MLPs provided care in half of the 40,252 medical encounters and 89% of their contacts were managed without consultation with or referral to the M.D. They managed 36% of first-year visits, 51% of second-year visits, and 54% of third-year visits. Concurrent with this shift in patient care responsibility from M.D. to MLP, differences in the types of conditions managed by M.D. and MLP decreased with time. Population surveys indicate that consumer satisfaction with MLP services is high and that health care from this system is perceived as being more accessible than care from alternative sources. In this setting the role of the MLP evolved in the direction of, but was not limited to, that of an M.D. substitute. Experience with this delivery system suggests that, as members of a health care team, MLPs can manage a majority of problems encountered in rural primary care with a high level of consumer satisfaction and improved access.

R-1 (1450g) and R-2 (25,000g) liver fractions from T/t6 and B6CBAF1 hybrid mice were analyzed for their protein content, mitochondria concentrations, and activities of three respiratory-chain enzymes of the mitochondrial inner membrane: cytochrome c oxidase (ferrocytochrome c: oxygen oxidoreductase, E.C. 1.9.3.1), α-glycerophosphate dehydrogenase [l-glycerol-3-phosphate: (acceptor) oxidoreductase, E.C. 1.1.99.5], and succinate-cytochrome c reductase. Only cytochrome c oxidase activity, calculated as units per 1010 mitochondria, was significantly lower in both R-1 and R-2 fractions of T/t6 mice. Cytochrome c oxidase activity varied greatly among T/t6 mice, as did their liver mitochondria concentrations and body weights. Cytochrome c oxidase activity in the R-1 fraction of T/t6 mice, calculated as units per 1010 mitochondria per gram of body weight, averaged about 40% lower than in B6CBAF1 mice. α-Glycerophosphate dehydrogenase activity was often elevated in T/t6 mice, particularly in the R-2 fraction. The T/t locus, a complex genetic locus on chromosome 17, may contain genes important to the function and biogenesis of mitochondria.

Genetic analyses, involving backcross and F2 matings, demonstrate that the type I hyperprolinemia of PRO/Re mice is caused by an abnormal allele at a single locus designated pro-1. Mice homozygous for this allele (pro-1 b /pro-1b) possess a deficiency in the activity of component 1 of mitochondrial proline dehydrogenase. In liver mitochondria of normal C57BL/6J mice, two proline dehydrogenase activity components are demonstrable by electrophoretic resolution of Triton X-100 solubilized extracts. In mitochondria of PRO/Re mice, the activity of component 1 is not readily detectable. Residual proline dehydrogenase activity in PRO/Re mitochondria appears, therefore, to be due in large measure to activity component 2 which is more stable to incubation at 40 C, exhibits slower electrophoretic mobility, and is less reactive to menadione. Kinetic analyses demonstrate a K m (proline) for the Triton X-100 solubilized enzyme activities of PRO/Re and C57BL/6J liver mitochondria of 0.4 M and 2.9×10−3M, respectively. C57BL/6J enzyme activity is inhibited by high substrate concentration. The activity of component 1 was not detected in other subcellular fractions of PRO/Re liver obtained by differential centrifugation. Abnormal control of respiratory chain function in PRO/Re mitochondria appears to involve primarily proline oxidation, as indicated by the level of activity of several inner membrane enzymes.

The concentration of taurine in fresh urine samples of hyperprolinemic PRO/Re mice taken daily for five days was about 18.0 μmoles per ml urine compared to 3.2 for CBA/J mice. The concentration of taurine in plasma of PRO/Re mice was not elevated compared to CBA/J or C57BL/6J mice. When CBA/J mice are treated with proline the concentration of taurine in the urine increased.

Studies on the genetic mechanisms in control of mouse liver tyrosine aminotransferase expression were of three general types: (1) studies on strain variance in endogenous enzyme activity and of various factors affecting the basal enzyme level, (2) purification of the enzyme and studies of its properties, and (3) studies of strain variance in enzyme regulation dealing primarily with glucocorticoid induction and with the starvation-induced enzyme adaptation. Tyrosine aminotransferase (l-tyrosine: 2-oxoglutarate aminotransferase, E.C. 2.6.1.5) was purified 400 to 600-fold from livers of C57BL/6J and DBA/2J inbred mice. Several of the properties of the mouse liver enzyme were similar to those known for the rat liver enzyme although the apparent Km (l-tyrosine) was lower, calculated at 6.25×10−4M. Disc gel electrophoresis of the enzyme from 105,000 g supernatant fluid after induction by hydrocortisone indicated three bands of enzyme activity with strain variance in electrophoretic mobility between the C57BL/6J and DBA/2J mice. The administration of glucose to fasting C57BL/6J mice “repressed” the starvation-induced increase in enzyme activity, but did not prevent the hydrocortisone induction of enzyme activity. DEAE-cellulose chromatography of purified enzyme from fasting DBA/2J and C57BL/6J mice which had been labeled in vivo with C 14 -l-leucine revealed strain differences in the elution patterns for both enzyme activity and radioactivity. Two peaks of enzyme activity were detected in the enzyme preparations from fasting mice. The marked strain variance in the enzyme activity and the quantity of radioactivity associated with the first enzyme peak may indicate differential rates of protein turnover for different isozymic forms of tyrosine aminotransferase. Flumethasone, a potent difluoro synthetic glucocorticoid, was used in studies on the hormonal regulation of tyrosine aminotransferase in obese mutant mice of the C57BL/6J-ob strain. The obese mice are relatively insensitive to the action of adrenal glucocorticoids to cause liver enzyme induction.

1.1. Tyrosine aminotransferase (TA) activity of the liver increases when mice are fasted.2.2. The onset and extent of the enzyme adaptation varied greatly among the inbred strains and mutant mice studied.3.3. In the C57BL/6J mice, the basal level of TA activity increased 4-fold within 60 hours of food deprivation. In the DBA/2 J mice, the TA activity remained low throughout the test period.4.4. Food deprivation also abolished or diminished markedly the diurnal variation of TA activity in certain inbred strains.5.5. Comparative studies on fasting genetically obese C57BL/6J-ob and pituitary dwarf DW-dw mice demonstrated significant influence of these mutant gene systems on the metabolic control of TA activity.

The activity of mouse liver l -tyrosine-2-oxoglutarate aminotransferase can be induced to high levels in 4 to 6 hr by the administration of the synthetic difluoro glucocorticoid, flumethasone (6α, 9α-difluoro-11β, 17α 21-trihydioxy-16α-methyl-pregna-1, 4-diene-3, 20-dione). A single injection of flumethasone to adrenalectomized C57BL/6J mice at a dose of 10 −8 moles (0.4 μg) per kilogram of body weight resulted in a 10-fold induction of enzyme activity in approximately 4 hr. In comparison, the administration of hydrocortisone sodium succinate (Solu-Cortef) at doses of 5.0 × 10 −5 (24.2 mg) and 10 −6 moles (0.48 mg) per kilogram of body weight resulted in a 4-fold and no detectable elevation of enzyme activity, respectively, after 4 hr. The effect of enzyme induction was maintained for a longer period of time by flumethasone than by the hydrocortisone derivatives tested. Dietary status markedly influenced the extent of the induction by flumethasone as demonstrated by the enhancement of enzyme induction by fasting in DBA/2J mice or by a controlled feeding schedule in C57BL/6J mice. Studies on the glucocorticoid regulation of liver enzyme synthesis in C57BL/6J- ob (obese mutant) mice demonstrated that flumethasone was significantly more effective than hydrocortisone derivatives as an inducer of liver tyrosine aminotransferase activity.