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Certain inflammatory stimuli such as thioglycollate medium, asbestos, and endotoxin are able to elicit macrophages into the peritoneal cavity of mice which synthesize and secrete increasing amounts of the neutral protease, plasminogen activator 1, 2 ; . The product of the interaction of this enzyme with the circulating proenzyme plasminogen is another neutral protease, plasmin, that is known to activate certain enzyme cascades relevant to the inflammatory response, viz., the complement 3 ; , the clotting 4 ; , and the kinin systems 5 ; . Macrophages are an important cell type in chronic inflammatory lesions and it has previously been suggested that plasminogenactivator production by macrophages might play a role in the traffic of macrophages through the body 6 ; . The inhibition of enzyme production by anti-inflammatory glucocorticoids and hence inhibition of cell migration might account for some of the anti-inflammatory properties of these drugs 6 ; . In contrast, agents such as phorbol myristate acetate, eoncanavalin A, and lymphocyte-conditioned medium can cause macrophages to produce more enzyme 7, 8 ; . Little is known about how macrophages modulate plasminogen activator levels in response to the various agents and a study of the regulation of enzyme production might be important for the understanding of maerophage physiology and function. In addition, information about the anti-inflammatory properties of glucocorticoids and about the mechanism of action of these drugs at a cellular level might be obtained by studying how they inhibit plasminogenactivator production by macrophages. Recently, several mouse monocyte-macrophage tumor lines have been shown to exhibit certain properties similar to their nonneoplastic counterparts, viz., adherence properties, phagocytosis, lysozyme synthesis, production of colony-stimulating activity, receptors for Fc and complement, the ability to lyse tumor cell targets, and prostaglandin synthesis 9, 10 ; . Thus, these cell lines offer the potential as models to study monoeyte-macrophage physiology and function and, because large populations of homogeneous cells can be obtained, can provide sufficient material for the isolation of receptors, enzymes, etc. In addition, the problem of contaminating cell types in tissue culture experiments is avoided. We show here that one such macrophage cell line, RAW264.10, synthesizes and secretes plasminogen activator spontaneously and that the synthesis of the enzyme can be inhibited by low concentrations of anti-inflammatory glucoeorticoids but is stimulated by low concentrations of the tumor promoter, phorbol myristate acetate. * Supported in part by grants PCM77-09114and PCM75-19734 from the NationalScienceFoundation. J. Exp. ME. The RockefellerUniversityPress . 0022-1007 78 0901-081151.00 and minocycline, for example, vasodilators. Some guidelines for pediatric patients can facilitate safe and effective anesthesia and surgery: ensure kittens have a complete physical exam prior to surgery; are vaccinated and treated for parasites several days before; postpone surgery if any abnormalities are found such as cryptorchidism ; weigh each kitten accurately to the nearest 100g ; to calculate drug doses combat hypoglycemia by withholding food for only 3-4 hours before surgery; feed a small meal within 1 hour of recovery from anesthesia keep kittens with their littermates before surgery in a warm, quiet environment to decrease excitement and stress; minimize handling; use im injections rather than iv to minimize restraint and stress treat kittens with a prolonged recovery or who will not eat after recovery with 50% dextrose given orally combat hypothermia with insulation against cold surfaces re-circulating warm water blankets ; during induction and surgery; minimize hair coat clipping; avoid alcohol in surgical preps; warm surgical prep solutions; check rectal temperature at the end of surgery; postoperatively, use warm blankets, hot water bottles, or heat lamps but monitor closely to avoid thermal injury ; references: aronsohn mg, faggella am.

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CHRISTOPHER EARLEY, MD: Hello and welcome to this program on sleep disturbances in the elderly population. I'm your host, Dr. Christopher Earley. I'm Associate Professor of Neurology at Johns Hopkins Medical Institution. Joining me to discuss this topic is Dr. David Neubauer. He's Assistant Professor of Behavioral Sciences at the Johns Hopkins Medical Institution. And via satellite, I would also like to welcome Dr. Rafael Pelayo. He is Assistant Professor at the Stanford University School of Medicine and at the Lucille Packard Children's Hospital. Welcome to you both. Complaints of sleep disturbances are common in the elderly population. Typical symptoms of sleep disturbances in this population include difficulty falling asleep and in maintaining sleep, difficulty with early morning awakening, and excess of daytime sleepiness. I would like to start this program off by examining a case of a female patient who has been experiencing sleep disturbance for many years. David, can you do your presentation? Thank you and cycrin.
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14. Neutel CI. Risk of traffic accident injury after a prescription for a benzodiazepine. Ann Epidemiol 1995; 5: 239--244. * 15. Hemmelgarn B, Suissa S, Huang A, Boivin J-F, Pinard G. Benzodiazepine use and the risk of motor vehicle crash in the elderly. JAMA 1997; 278: 27--31. * 16. Barbone F, McMahon AD, Davey PG et al. Association of roadtraffic accidents with benzodiazepine use. The Lancet 1998; 352: 1331--1336. McGwin G, Sims RV, Pulley L, Roseman JM. Relationship among chronic medical conditions, medications, and automobile crashes in the elderly: a population-based casecontrol study. J Epidemiol 2000; 152: 424--431. Thomas RE. Benzodiazepine use and motor vehicle accidents. Systematic review of reported association. Can Fam Physician 1998; 44: 799--808. af Wahlberg AE. Some methodological deficiencies in studies on traffic accident predictors. Accid Anal Prev 2002; 859: 1--14. Parrott AC. Performance tests in human psychopharmacology 1 ; : test reliability and standardization. Hum Psychopharmacol 1991; 6: 1--9. Parrot AC. Performance tests in human psychopharmacology 2 ; : content validity, criterion validity, and face validity. Hum Psychopharmacol 1991; 6: 91--98. Galski T, Ehle HT, Bruno RL. An assessment of measures to predict the outcome of driving evaluations in patients with cerebral damage. J Occup Ther 1990; 44: 708--713. Kapust LR, Weintraub S. To drive or not to drive: preliminary results from road testing of patients with dementia. J Geriatr Psychiatry Neurol 1992; 5: 210--216. Nouri FM, Lincoln NB. Predicting driving performance after stroke. Br Med J 1993; 307: 482--483. Odenheimer GL, Beaudet M, Jette et al. Performancebased driving evaluation of the elderly driver: safety, reliability, and validity. J Gerontol 1994; 49: M153--M159. 26. Fitten LJ, Perryman KM, Wilkinson CJ et al. Alzheimer and vascular dementias and driving. A prospective road and laboratory study. JAMA 1995; 273: 1360--1365. Korteling JE, Kaptein NA. Neuropsychological driving fitness tests for brain-damaged subjects. Arch Phys Med Rehabil 1996; 77: 138--146. Duchek JM, Hunt L, Ball K et al. Attention and driving performance in Alzheimer's disease. J Gerontol 1998; 53B: P130--P141. 29. Marottoli RA, Richardson ED, Stowe MH et al. Development of a test battery to identify older drivers at risk for self-reported adverse driving events. JAGS 1998; 48: 562--568. McKnight AJ, McKnight AS. Multivariate analysis of agerelated driver ability and performance deficits. Accid Anal Prev 1999; 31: 445--454. Lundqvist A, Gerdle B, Ronnberg J. Neuropsychological aspects of driving after a stroke--in the simulator and on the road. Appl Cognitive Psychol 2000; 14: 135--150. Myers RS, Kalina TD, Roth DL et al. Relation of useful field of view and other screening tests to on-road driving performance. Percept Mot Skills 2000; 91: 279--290. Schanke A, Sundet K. Comprehensive driving assessment: neuropsychological testing and on-road evaluation of brain injured patients. Scand J Psychol 2000; 41: 113--121. De Raedt R, Pontjaert-Kristoffersen I. Short cognitive neuropsychological test battery for first-tier fitness-todrive assessment of older adults. Clin Neuropsychol 2001; 15: 329--336. Lundqvist A. Neuropsychological aspects of driving characteristics. Brain Injury 2001; 15: 981--994. INHIBITORS Clonidine Catapres ; 0.1mg, 0.2mg, 0.3mg TabletsBCF Doxazosin Cardura ; 2mg, 4mg, 8mg Tablets Methyldopa Aldomet ; 250mg Tablets Prazosin Miniptess ; 1mg, 2mg, 5mg CapsulesBCF, DoD Terazosin Hytrin ; 1mg, 2mg, 5mg, CapsulesBCF.

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